Preliminary Exploration For Iris Fixation Of Foldable Intraocular Lenses In The Absence Of Capsule Support

Objective: To evaluate the application and effect of iris fixation of foldable intraocular lenses in the absence of capsule support.Methods:Aphakia cases without normal lens capsular support at the Second Hospital of Shandong University From January 2008 to January 2010 except for the cases with corneal astigmatism more than 1.5D or best corrected visual acuity less than 0.1, were divided into an observe group and a control group using the method of random digit. For the 13 cases in the observe group,3.0mm transparent cornea incision was made in transparent cornea, and a foldable IOL was implanted in posterior chamber using unfolder with both loops sutured in iris by 10-0 polypropylene. All the patients were followed up for 3 months. The preoperative naked vision, BCVA, refractive status, anterior segment, intraocular pressure; postoperative naked vision, BCVA, refractive status, anterior segment,intraocular pressure and complications were summarized, naked vision, BCVA, surgery induced astigmatism(SIA),the differences between postoperative residual refractive and preoperative expectations and the intraocular pressures(IOP) were analyzed and compared with the control group of 10 cases for implantation scleral-fixed foldable intraocular lenses using tweezers through a 4.0mm transparent cornea incision.Results:There was no significant statistical difference between the observe group and the control group in preoperative naked vision and BCVA, but the postoperative naked vision in the observe group is greater than that in the control group after three months (t=2.258, P=0.035)。The differences between postoperative residual refractive and preoperative expectations and the the surgery induced astigmatism(SIA) in the observe group are both less than those in the control group (for former, t=2.363, P=0.028; for SIA, t=3.77, P=0.01)。There was no significant statistical difference between the IOPs of two groups whether before or after operation. In the observe group, all the IOLs were in proper places. However, intraocular lens decentration has accured in one case of the control group. No serious complications were found in all the cases.Conclusions:For the aphakia without a sufficient posterior capsular lens supported,the iris fixation of foldable intraocular lens compared with scleral fixation is a safe, effective and feasible method for the advantages of better postoperative visual acuity, smaller surgery induced astigmatism, better intraocular lens predictability, and fewer postoperative complications.