Three-year follow-up of secondary anterior iris fixation of an aphakic intraocular lens to correct aphakia

PURPOSE: To evaluate the efficacy, predictability, stability, safety, and complications of secondary anterior iris fixation of the Artisan iris-fixated intraocular lens (IOL) to correct aphakia in eyes without sufficient capsule support. SETTING: Department of Ophthalmology, Jinling Hospital, School of Medicine, Nanjing University, Nanjing, China. DESIGN: Cohort study. METHODS: Eyes having implantation of aphakic iris-fixated IOLs for aphakia correction were followed for 3 years. RESULTS: The study evaluated 72 eyes (72 patients). After 3 years, the uncorrected distance visual acuity improved in all eyes (P<.05); 53 eyes (73.6%) reached 20/40 or better. Two eyes had a postoperative corrected distance visual acuity (CDVA) worse than the preoperative CDVA due to postoperative ischemic optic neuropathy and retinal detachment, respectively. The mean spherical equivalent (SE) decreased from 11.65 diopters (D) +/- 1.21 (SD) to -0.58 +/- 0.56 D (P<.05); the SE at the last follow-up was within +/- 1.00 D of the target refraction in 63 eyes (87.5%). The mean endothelial cell loss 3 years postoperatively was 9.78%. There was no significant postoperative intraocular pressure increase throughout the follow-up. Twelve patients (16.7%) reported glare and halos during night driving. Iris pigment precipitates on the IOLs occurred in 4 eyes (5.6%) 3 years postoperatively. No other serious complications occurred. CONCLUSIONS: Three-year results indicate that secondary implantation of aphakic IOLs is effective, predictable, and safe for the correction of aphakia in eyes without capsule support. However, longer follow-up with a larger cohort is necessary to confirm these conclusions.