Safety and efficacy of posterior iris claw intraocular lens fixation in aphakic patients

  • Rosemary Tomy Ahalia Foundation Eye Hospital
  • Rajkumar Maheshwari Ahalia Foundation Eye Hospital
  • Ansa Parveen Kunhu Muhammed Ahalia School of Optometry
  • Venkataramana Kalikivayi Ahalia School of Optometry, Ahalia Foundation Eye Hospital
  • Sajeev Cherian Jacob Ahalia Foundation Eye Hospital
Keywords: aphakia, intraocular lens (IOL), iris claw


Purpose: To assess the indications and visual outcome of eyes undergoing posterior iris fixated intraocular lens (IFIOL) implantation for aphakia, to identify reasons for poor visual outcome, and report occurrence of complications.

Methods: In this retrospective case series study, all cases of posterior IFIOL fixation performed over a 30-month period were identified retrospectively. Preoperative and postoperative evaluations comprised objective and subjective refraction, best corrected visual acuity (BCVA), slit lamp biomicroscopy, applanation tonometry, and dilated fundus examination.

Results: Fifty-six eyes of 56 patients were analyzed. Mean age was 60.55 ± 17.2 years. The most common indication for IFIOL implantation was surgical aphakia following complicated cataract surgery (n = 33; 58.9%) followed by trauma (n = 10; 17.9%), dropped nucleus/IOL during primary surgery (n = 6; 10.7%), and subluxated/dislocated lens-induced glaucomas (n = 5; 8.9%). BCVA better than or equal to their preoperative BCVA was achieved in 96.43% patients. The surgical aphakia and paediatric/adolescent groups had the best visual results while the dropped nucleus/IOL group and subluxated lens-induced glaucoma groups fared poorly. On the long-term follow-up visit, the most common complication noted was pigment dusting on the corneal endothelium (65.7%).

Conclusion: The long-term results suggest that posterior IFIOL implantation is a safe and effective method for correction of aphakia and can be used for a wide range of indications in eyes without adequate capsule support. It may be considered an easier and faster alternative with minimal manipulation to anterior segment structures in paediatric and post-traumatic aphakic eyes.

Author Biographies

Rosemary Tomy, Ahalia Foundation Eye Hospital

Consultant Ophthalmologist

Rajkumar Maheshwari, Ahalia Foundation Eye Hospital
Consultant Ophthalmologist and Director-Retina Department
Ansa Parveen Kunhu Muhammed, Ahalia School of Optometry
Student of Ahalia School of Optometry
Venkataramana Kalikivayi, Ahalia School of Optometry, Ahalia Foundation Eye Hospital

Head of the Department

Ahalia School of Optometry

Sajeev Cherian Jacob, Ahalia Foundation Eye Hospital
Consultant Ophthalmologist and Medical Director


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How to Cite
Tomy, R., Maheshwari, R., Kunhu Muhammed, A. P., Kalikivayi, V., & Jacob, S. (2018). Safety and efficacy of posterior iris claw intraocular lens fixation in aphakic patients. Asian Journal of Ophthalmology, 16(2), 124-133.
Case Reports/Case Series