Long term safety and efficacy of iris claw versus scleral fixated intraocular lens for management of ectopia lentis

Propose : to compare between iris claw anterior chamber intraocular lens (ACIOL) and scleral fixated posterior chamber (PCIOL) regarding long term safety and efficacy in cases with ectopia lentis. Patients and methods: This cohort study was conducted at Mansoura Ophthalmic Center, faculty of medicine, Mansoura University. It included 59 eyes of 34 patients who underwent surgery for ectopia lentis with IOL implantation (30 eyes with scleral fixation IOL & 29 eyes with Iris claw ACIOL) in the period from May 2010 to January 2014. All cases were subjected to history taking, full ophthalmological examination (visual acuity, cyclorefraction, anterior and posterior segment examination), endothelial cell density (ECD), central macular thickness (CMT). Regular follow up visits were scheduled to assess the efficacy and complication of each approach. Results: Visual acuity and refraction showed significant improvement after surgery in both groups without significant difference. Endothelial cell density decreased significantly in both groups compared to the preoperative values. Moreover, the scleral fixation group showed significant increase in macular thickness compared to its preoperative values. However, no significant difference was detected between the two groups. Lens displacement occurred in 4 and 11% of cases in both groups respectively. Conclusion: Both iris claw ACIOL and scleral fixated PCIOL are safe and effective techniques in the management of ectopia lentis.