Anterior chamber and retropupillary iris-claw intar ocular lens fixation comparison of clinical outcomes: a systematic review.

BACKGROUND

In cataract surgery, optimal intraocular lens (IOL) placement is typically within the capsular bag. However, in the absence of sufficient capsular support, alternative techniques such as scleral-sutured IOLs, anterior chamber IOLs, and iris-fixated IOLs either in the anterior chamber or retropupillary are employed. The choice between these methods depends on factors like surgeon expertise, patient-specific anatomy, and clinical circumstances, with anterior chamber iris-claw IOLs offering a more straightforward approach and retropupillary techniques potentially providing additional benefits requiring advanced skills.

OBJECTIVE

This systematic review aims to evaluate the clinical outcomes of anterior chamber versus retropupillary iris-claw IOLs fixation.

METHODS

Adhering to the Preferred Reporting Items for Systematic Review and Meta-analysis guidelines, a comprehensive literature search was conducted using PubMed, Cochrane Central, Scopus, and Web of Science databases until May 2024. These searches focused on specific terms related to the methods, and data were extracted using a standardized online sheet.

RESULTS

The review encompassed nine studies, including two randomized control trials (RCTs) and seven observational studies (Cohort and case controls). A total of 714 patients were evaluated, comprising 295 females (41.3%) and 419 males (58.7%), with a mean age of 60.11 years (SD = 10.22).

CONCLUSION

The studies underscore the ongoing debate regarding the optimal surgical approach for IOL implantation in cases of insufficient capsular support. Both anterior chamber and retropupillary techniques demonstrates efficacy, with the latter offering potential advantages through retropupillary iris-claw IOL implantation via scleral approach. However, larger-scale studies with longer follow-up periods are still needed to definitively establish the relative merits of the different procedures.