Retropupillary fixation of iris-claw intraocular lens versus transscleral suturing fixation for aphakic eyes without capsular support.

PURPOSE Retropupillary fixation of an iris-claw intraocular lens (IOL) (Verisyse, Abbott Medical Optics) was performed for aphakic eyes without sufficient capsular support, and safety and recovery of the procedure were compared with transscleral suturing fixation. METHODS This interventional case series comprised 11 eyes of 10 aphakic patients without capsular support undergoing retropupillary fixation of the Verisyse, and 21 eyes of 20 patients undergoing transscleral suturing fixation of foldable acrylic IOLs (15 eyes of 14 patients, SuperFlex620H [Rayner Intraocular Lenses Ltd]) and polymethylmethacrylate IOLs (6 eyes of 6 patients, CP60NS [CORNEAL Laboratoire]). Surgical time was measured. Corrected distance visual acuity (CDVA) and intraocular pressure (IOP) were examined preoperatively and 1 day, 1 and 2 weeks, and 1 and 6 months postoperatively. RESULTS No complications occurred in the Verisyse group, whereas complications were reported in seven eyes in the transscleral suturing fixation group throughout follow-up. Mean CDVA (logMAR) in the transscleral suturing group 1 day after surgery was significantly worse than preoperative CDVA (P<.05). In the Verisyse group, no significant changes in CDVA were noted at any time point. Mean IOP at postoperative day 1 in the transscleral suturing fixation group was significantly higher than that in the Verisyse group (P=.0126). Mean surgical time of Verisyse implantation (20.0 ± 8.9 min) was significantly shorter than transscleral suturing fixation (49.7 ± 18.9 min) (P<.0001). CONCLUSIONS Retropupillary fixation of an iris-claw IOL provides early visual recovery, has a low risk of postoperative increase in IOP, and is a time-saving method compared with transscleral suturing fixation for aphakic eyes without sufficient capsular support.