Retropupilar positioning of foldable iris-claw intraocular lens for correction of aphakia with no capsular support

Mun Yueh Faria,1-3 Nuno Pinto Ferreira,1-3 Ivo Gama,1-3 Joana Medeiros Pinto,1-4 Mario Canastro,1-3 Manuel Monteiro Grillo1-3 1Hospital Santa Maria, Ophthalmology Department, 2Vision Study Center, University of Lisbon, 3Faculty of Medicine, University of Lisbon, Lisbon, 4Hospital Divino Espirito Santo, Ponta Delgada, Portugal Summary: Iris-claw intraocular lens (ICIOL) for aphakia needs a large 5.4 mm corneal incision for its implantation. The technique needs corneal suture, associated with some postoperative astigmatism. Foldable ICIOL is used in phakic patients undergoing refractive surgery and has the advantage of a sutureless small corneal incision. We report a case of a high myopic patient with dislocated intraocular lens (IOL) and no capsular support. Dislocated IOL with its capsular bag was released with three-port, 23-gauge vitrectomy; placed in the anterior chamber; sliced; and extruded through a 3.2-mm corneal incision, where a foldable ICIOL was introduced and placed retropupillary. This technique achieved a stable fixation of the IOL. Retropupillary implantation of a foldable ICIOL on aphakic patients has advantages over that of a polymethylmethacrylate (PMMA) ICIOL due to smaller corneal incision. The technique may be safe and easy to perform.Purpose: The purpose of this report was to describe the technique of retropupillary implantation of a foldable iris-claw intraocular lens (ICIOL) in a patient with dislocated intraocular lens (IOL) in mid vitreous cavity.Methods: Foldable ICIOL (Artiflex® Myopia Model 401) is used in phakic patients undergoing refractive surgery and has the advantage of a sutureless small corneal incision. We report a case of a high myopic patient with dislocated IOL and no capsular support. The calculation was a -5.0 D IOL for retropupilar position, and a foldable ICIOL was introduced through a 3.2-mm corneal incision and placed retropupillary.Results: The technique was easy to achieve. IOL was properly positioned retropupillary and maintained stable. There was no ocular hypertension and no anterior chamber flare or iris atrophy.Conclusion: Retropupillary implantation of a foldable ICIOL on aphakic patients has advantages over that of a PMMA ICIOL due to smaller corneal incision. The technique may be safe and easy to perform. Keywords: aphakia, dislocated IOL, foldable iris-claw IOL, retro iris IO