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Clinical Characteristic and Outcomes of Aphakic Iris-Claw Intraocular Lens Implantation (Artisan) in Prof Ngoerah General Hospital on August 2019-July 2022

Siska, Ni Luh Putu Nurindah Sukmawati, I Wayan Gede Jayanegara, AA Mas Putrawati Triningrat, IB Putra Manuaba.

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Background: Conditions such as posterior capsular rupture, pseudoexfoliation syndrome, high myopia or Marfan's syndrome may cause inadequate posterior capsule support. Implantation of an anterior chamber IOL , iris-sutured IOL, scleral fixation IOL, or iris-claw IOL may be considered in these conditions. Iris-claw implantation is often preferred due to its convenience and timesaving in use but the visual outcomes in Prof Ngoerah General Hospital has not yet published.
Material and Methods: This retrospective observational study was aimed to determine the characteristics and outcomes of iris-claw (Artisan) IOL implantation. Data was obtained before, after one week and 30 days implantation at Sanglah Hospital from August 2019-July 2022. Patient characteristics were analyzed with descriptive analysis and presented as frequency, percentage, mean and standard deviation. The differences between visual acuity, intraocular pressure and endothelial cell count were analysed using paired T-test and Wilcoxon signed rank test.
Results: This study consisted of 21 eyes with the mean age was 45,38±25,86 years. The most common primary procedure was caused by secondary aphakia in 6 (28,6%) patients and lens subluxation and zonular weakness (due to high myopia) in 5 patients (23,8%). A total of 13 (61,9%) were implanted in the prepupillary. There was a significant increase in visual acuity from 1.69 ±0.76 logMAR to 0.50±0.33 logMAR after one week and constantly increase from one week to 0.37±0.27 after 30 days follow up (p=0.046). The complication reported was one patient (4,7%) with temporary increasing intraocular pressure. Spherical residual were mostly under -1.0 D (57.1%) and cylindrical residual were 9 (42.8%) less than -0,50D. Endothelial cell density were decreasing 2.1% from 2673.81 (948) cell/mm2 to 2616.9(800) cell/mm2 but the reduction were not statistically significant (p=0.192). There was no difference of intraocular pressure before and after implantation (p=0.638).
Conclusion: This study showed that the implantation of iris claw lens were safe, has faster recovery and effective for either primary or secondary procedure.

Key words: Iris-claw, intraocular lens, aphakia

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