Comparison of anterior and posterior chamber implantation of iris claw lens in corneal transplant patients

PURPOSE: This study aims to compare the surgical outcomes of anterior chamber (AC) and posterior chamber (PC) implantation of iris claw lens (ICL) combined with penetrating corneal transplantation (P-CT), in eyes with no capsular support.

METHODS: The records of 20 P-CT cases who underwent ICL implantation were retrospectively evaluated. The eyes were grouped according to the location of implantation; AC ICL and PC ICL. Pre- and post-surgical best-corrected visual acuity (BCVA), post-operative complications, and graft rejection rates were compared between the two groups. Mean follow-up time was 28 (range, 12 and 76) months.

RESULTS: ICLs were implanted during P-CT surgery in 14 (70%) eyes and as a secondary procedure after P-CT in 6 (30%) eyes. ICLs were implanted in PC in 12 (60%) and in AC in 8 (40%) eyes. Mean pre-operative BCVA was 0.064 (range, 0.001–0.02) in the PC group and 0.02 (range, 0.001–0.1) in the AC group (p=0.86). Mean post-operative BCVA was 0.17 (range, 0.0001–1.0) in the PC group and 0.14 (range, 0.0001–0.4) in the AC group (p=0.81). Glaucoma developed in 5 (41.6%) eyes with PC ICL. No eye with AC ICL developed glaucoma overtime.

CONCLUSION: Both AC and PC ICL implantations provide favorable visual outcomes and complication rates in CT patients. However, PC implantation of ICL seems to increase glaucoma incidence.