Iris claw to the rescue - A case series

Abstract

The utility of retropupillary (RP) iris-fixated lenses, even when the iris support is deemed inadequate is portrayed in this case series. The case series emphasizes iris-claw lens as an effective alternative in cases where there is a disfigurement of the iris with meticulous surgical skills. A 58-year-old with diminution of vision in the right eye for 6 months had a vision of 6/60, iris coloboma inferiorly with zonule loss and cataractous lens. Manual small-incision cataract surgery (M-SICS) was performed with placement of iris-claw lens despite the presence of iris disfiguration. A 62-year-old male with diminution of vision in the left eye had a vision of counting fingers at 1 m. On slit-lamp examination, iris atrophy, an oval-shaped pupil with a maximum of 5 mm eccentric dilation, cataractous lens inferiorly subluxated and partially absorbed, a breach in the anterior capsule, and vitreous strands were noted in the anterior chamber. M-SICS with iris-claw lens was then performed. A 3-year-old female child with a history of trauma to the left eye had a vision of perception of light only. On anterior segment evaluation, she had radial, full-thickness corneoscleral tear with iris plugging the wound, iris trauma, and traumatic immature cataract. Left eye corneal tear repair with cataract extraction and iris-claw insertion was performed. Postoperative vision on follow-up after a month was 6/12p in all three cases. Iris claw lens being readily available, and surgical technique of insertion being easy and quick, serves as one of the effective alternatives for the intraocular lens in difficult situations.