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Retropupillary iris-claw intraocular lens and pars plana vitrectomy in aphakia management: A national multicenter audit.

PURPOSE
To evaluate the outcomes and safety of retropupillary iris-claw intraocular lens (RICI) implantation and associated pars plana vitrectomy (PPV).


METHODS
Multicenter, national audit of 325 eyes (325 patients). Demographics, surgical details, and complications are described. Visual acuity (VA), intraocular pressure (IOP) and central retinal thickness assessed by OCT were collected at 1, 3, 6 and 12 months after surgery. Kaplan-Meier curves were created to assess the cumulative probability of postoperative VA and IOP levels, macular edema (ME) development and corneal decompensation.


RESULTS
The cumulative probability of final VA ≤0.3 logMAR (≥20/40 Snellen) was 75.6% at 12-months follow-up. The probability of IOP >21, ≥25 and ≥30 mmHg was 48.1%, 33.1% and 19.0%, and the probability of IOP-lowering drops was 50.9% at 12 months. Glaucoma surgery was required in 4.3% of the eyes (14/325). The cumulative probability of ME was 20.5% at 12-months and was greater in complicated cataract surgery than in IOL-luxation eyes (26% vs 16.7%, p=0.04). Corneal transplantation was required in 2.8% of the eyes (9/325).


CONCLUSION
This study on 325 eyes with aphakia or IOL dislocation managed with the RICI technique provides clinical outcomes in a real-world scenario, reporting relevant data for patient counselling and preoperative discussions.