1. Department of ophthalmology,
Russian peoples friendship university, Moscow
Ophthalmic unit of Skhodnya city hospital,
Moscow region, Russia
LONG TERM RESULTS OF RETROPUPILLARY
FIXATION OF AN IRIS-CLAW INTRAOCULAR LENS
(ICIOL) IN MANAGEMENT OF COMPLICATIONS
DURING PHACOEMULSIFICATION.
Mikhail Aleksandrovich Frolov , Vinod Kumar, Isufaj Edmond
Innovative educational program of the university
FINANCIAL DISCLOSURE: none.

2. INTRODUCTION
The ideal and best place for IOL implant is in the
capsular bag.
However in the presence of an unstable capsule-zonule
complex or its absence, endocapsular fixation of an IOL is
a difficult target to achieve and the surgeon has four
following options:
to implant an ACIOL;
to fixate a PCIOL in the iris;
to fixate a PCIOL in the sclera;
to leave the eye aphakic.
Department of ophthalmology, Russian peoples friendship university, Moscow

3. Purpose: To evaluate long term results of retropupillary
fixation of ICIOLs in management of intraoperative
complications during phacoemulsification.
Setting: Department of ophthalmology,
Russian People’s Friendship University, Moscow
Ophthalmic unit of Skhodnya city hospital,
Moscow region, Russia.
Department of ophthalmology, Russian peoples friendship university, Moscow

4. MATERIAL AND METHODS
• The study was done under the innovative educational
program of the university.
• Retropupillary fixation of an ICIOL in 21 eyes of 20
patients (9 male and 11 females).
• The patients age varied from 38 to 87yrs. (average age:
71,4+/-11,8 yrs.)
• Follow-up period from 1 year to 4 years.
Department of ophthalmology, Russian peoples friendship university, Moscow

5. MATERIAL AND METHODS
ICIOL was implanted during following intraoperative
complications :
•Posterior capsule rupture with vitreous prolapsed into anterior
chamber - 7 eyes.
•Zonular dehiscence - 14 eyes.
Department of ophthalmology, Russian peoples friendship university, Moscow

6. MAIN OUTCOME MEASURES
• Visual acuity
• Refraction
• Intraocular pressure (IOP) measured by Maklakov method
• IOL stability
Department of ophthalmology, Russian peoples friendship university, Moscow

7. SURGICAL TECHNIQUE

8. RESULTS
• Visual acuity of 0.5 or more was achieved in 15 cases (71.4%)
• During follow-up position of IOL remained stable in all cases.
• No new case of glaucoma was diagnosed.
• Iridopseudophacodonesis was prevalent in all cases.
• 5 cases (23.8%) with pupil deformation in the form of “cat
pupil” complained of glare.

9. RESULTS
• Depigmentation areas at enclavation
site, observed in most of the cases
(16 cases, 76.2%) were related to
surgical trauma while enclaving the
iris.
• Ultrasound biomicroscopy showed
contact between IOL and iris only
at enclavation site. IOL optic was
well away from iris tissue.

10. CONCLUSION
Analysis of long term results indicates safety and
effectiveness of retropupillary fixation of an ICIOL
in management of complications during
phacoemulsification.
Department of ophthalmology, Russian peoples friendship university, Moscow