The Secondary Intraocular Lenses Implantation In Aphakic Vitrectomized Eyes

Objective To compare the efficiency of foldable posterior chamber intraocular lens transscleral fixation and Artisan iris-claw intraocular lens for aphakic eyes without adequate capsule support after vitrectomy.Methods To retrospective analysis 22 aphakic eyes after vitrectomy without posterior capsular support in Tianjin eye hospital from October 2008 to February 2010.8 eyes in group A underwent Artisan iris-claw intraocular lenses implantation, and 14 eyes in group S were implanted foldable posterior intraocular lenses through transscleral fixation. Visual acuity(VA),best corrected visual acuity(BCVA),intraocular pressure(IOP) and corneal endothelial cells count were evaluated before surgery and 5days,2 months after surgery.Results Postoperative VA are better than preoperation in all patients. There was no significant statistical difference between the two groups in VA, BCVA, IOP and corneal endothelial cells count before surgery.5 days after operation,VA< 0.3,0.3-0.5,>0.5 in group S was 5 eyes (35.7%),7 eyes (50.0%) and 2 eyes (14.3%);in group A was 5 eyes (62.5%),2 eyes (25.0%) and 1 eye (12.5%), there was no significant statistical difference between the two groups(χ2=1.693, P>0.05).The patients with postoperative BCVA<0.3,0.3-0.5,>0.5 in group S was 2 eyes (14.3%),8 eyes (57.1%) and 4 eyes (28.6%);in group A was 2 eyes (25.0%),4 eyes (50.0%) and 2 eye (25.0%), there was no significant statistical difference between the two groups (χ2=0.157,P>0.05).The intraocular pressure of postoperative 5 days and 2 months were 13.9±2.12mmHg and 12.9±5.56mmHg in group S, 11.8±1.66mmHg and 13.7±1.64mmHg in group A. There were significant statistical difference(t=2.40,p<0.05) for 5 days and no statistical difference (t=0.39,p>0.05) for 2 months between the two groups.The corneal endothelial cells count were 2098.3±198.3/mm2 and 1984.2±182.18/mm2 in group S and group A, there was no significant statistical difference (t=1.33,p>0.05) between the two groups.Severe complications did not occur in each group. There were no significant intraocular lenses tilt and decentration in transscleral fixation group observed by UBM.Conclusions Transscleral fixation of foldable intraocular lenses and implantation of Artisan iris-claw intraocular lenses are both safe and effective methods for aphakic vitrectomized eyes inadequate capsule support. Transscleral fixation of foldable intraocular lenses have visual acuity recovered early with little complication.