Department of Ophthalmology, Oslo University Hospital, Oslo, Norway.
Institute of Clinical Medicine, University of Oslo, Oslo, Norway.
Acta Ophthalmol. 2021 Dec;99(8):826-836. doi: 10.1111/aos.14824. Epub 2021 Mar 8.
Iris-claw lenses have gained increasing popularity over the last years and are by many surgeons regarded as viable options in eyes with insufficient capsular or zonular support. The iris-claw lens has two haptics with fine fissures for folding (enclavating) the mid-peripheral part of the iris stroma and can either be placed in front of or posterior to the iris. In particular, the retropupillary implantation has been increasingly chosen probably due to having an anatomical position similar to that of the crystalline lens. The present review is based on a literature review and also on the authors' clinical experience with this lens, and it focuses on surgical techniques and outcomes especially related to the characteristics of this lens, having haptics with claws that fixate the lens to the posterior iris. Implanting retropupillary iris-claw lenses has a relatively short learning curve, and there are only few complications reported during surgery. Retropupillary iris-claw lenses have demonstrated generally favourable efficiency and safety. However, the outcomes are probably more influenced by the reason for surgery and eye comorbidity than the lens itself. Albeit seldom reported, the postoperative complications have mostly been related to atrophy of the iris at the site of the haptics, or IOL decentration or disenclavation of one of the haptics. To date, however, there are few randomized clinical trials comparing this lens to other lens alternatives in eyes exhibiting insufficient capsular or zonular support for placing the lens in the ciliary sulcus. In the future, prospective studies with large samples should be performed to gain insights into the long-term safety of retropupillary placed iris-claw lenses, and for comparisons with the various other techniques of lens fixation.
近年来，虹膜夹型人工晶状体越来越受到关注，许多外科医生认为，对于囊袋或悬韧带支持不足的眼睛，虹膜夹型人工晶状体是一种可行的选择。虹膜夹型人工晶状体有两个带有精细裂缝的襻，用于折叠（夹合）虹膜基质的中周边部分，可以放置在虹膜的前面或后面。特别是，后房植入越来越受到选择，可能是由于其解剖位置类似于晶状体。本综述基于文献回顾，以及作者对此类人工晶状体的临床经验，重点介绍了手术技术和结果，特别是与该人工晶状体的特点相关的技术和结果，该人工晶状体的襻带有爪子，可将人工晶状体固定在虹膜的后部。植入后房虹膜夹型人工晶状体的学习曲线相对较短，手术过程中报告的并发症很少。后房虹膜夹型人工晶状体的总体效率和安全性良好。然而，结果可能更多地受到手术原因和眼部合并症的影响，而不是人工晶状体本身。尽管很少有报道，但术后并发症大多与襻所在部位虹膜萎缩、人工晶状体偏心或其中一个襻脱离有关。然而，迄今为止，很少有随机临床试验将这种人工晶状体与其他用于在睫状沟放置人工晶状体的替代人工晶状体进行比较，这些人工晶状体用于囊袋或悬韧带支持不足的眼睛。未来，应进行前瞻性的大样本研究，以深入了解后房放置的虹膜夹型人工晶状体的长期安全性，并与各种其他晶状体固定技术进行比较。
