Gravitational pseudoaccommodation in patients with aphakic iris-claw intraocular lenses.

Lincke, Joel-Benjamin; Miller, Mathias; Ebneter, Andreas; Zinkernagel, Martin (2016). Gravitational pseudoaccommodation in patients with aphakic iris-claw intraocular lenses. Journal of cataract and refractive surgery, 42(10), pp. 1456-1460. Elsevier 10.1016/j.jcrs.2016.07.033

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PURPOSE

To assess whether iris-claw intraocular lenses (IOLs) undergo gravitation-dependent changes in position and refraction.

SETTING

Tertiary referral center, Bern, Switzerland.

DESIGN

Observational case study.

METHODS

Patients with a history of pars plana vitrectomy and IOL exchange with implantation of an aphakic iris-claw IOL (Artisan) were included in this study. Objective refraction was obtained with a handheld autorefractometer, and the IOL position was measured by ultrasound biomicroscopy with the patient prone, sitting, and supine.

RESULTS

Twenty-one eyes of 19 patients with retropupilary IOLs (13) or prepupillary IOLs (8) were included. The mean spherical equivalent (SE) in the sitting position was -0.81 diopter (D) ± 0.95 (SD), and the mean distance from the endothelium to the anterior edge of the IOL was 3.35 ± 0.72 mm. The mean SE in the supine position was -0.61 ± 1.28 D, whereas the mean SE in the prone position was -1.34 ± 1.17 D (P = .0030). The IOL position changed from 3.50 mm in the supine position to 3.06 mm in the prone position (P < .0001).

CONCLUSIONS

The aphakic iris-claw IOL was subject to significant movement related to gravity. The change in the refractive effect suggests that there is a degree of pseudoaccommodation caused by the forward shift of the aphakic IOL in the face-down position.

FINANCIAL DISCLOSURE

None of the authors has a financial or proprietary interest in any material or method mentioned.

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