Iris-fixated IOLs have several fixation options


Leigh Spielberg
Published: Friday, September 9, 2016
[caption id="attachment_5244" align="alignnone" width="750"]
Professor David Spalton at the combined ESCRS/EURETINA symposium[/caption]
“Our colleagues in The Netherlands have enormous experience with iris-fixated intraocular lenses (IOLs),” said David J Spalton FRCS, FRCP, FRCOphth, UK, when introducing Rudy MMA Nuijts MD, PhD, The Netherlands, prior to Dr Nuijts’ presentation at a combined EURETINA/ESCRS session in Copenhagen yesterday.
“Iris-fixated IOLs eliminate the problems with IOL sizing or damage to the anterior chamber (AC) angle that can be associated with AC IOLs. They’re a one-size-fits-all solution in the absence of capsular support,” said Dr Nuijts.
Iris-fixated IOLs have several fixation options. They can be attached to the anterior or posterior face of the iris in horizontal, vertical or oblique orientations, depending on the status of the iris tissue.
Dr Nuijts prefers retropupillary fixation. “It’s clear that the further the lens is away from the corneal endothelium, the better,” he said, since “annualised corneal endothelial cell loss is 2-3% for anteriorly-fixated IOLs.”
Complications specific to iris-fixated IOLs include anterior uveitis, iris depigmentation, pupillar distortion and spontaneous lens dislocation. These, however, compare favorably with complications due to intrascleral fixation of posterior chamber IOLs, which require more complicated surgery to implant and can lead to damage to the ciliary body and retinal detachment.
In addition to complicated cataract cases, iris-fixated IOLs can be used in patients operated for congenital cataract and lens subluxation in Marfan’s syndrome.
Despite a long history of good results to date, Dr Nuijts pointed out the need for prospective, long-term studies to compare iris-fixated versus sclera-fixated IOLs.

Latest Articles
Beyond the Numbers
Empowering patient participation fosters continuous innovation in cataract surgery.
Thinking Beyond the Surgery Room
Practice management workshop focuses on financial operations and AI business applications.
Aid Cuts Threaten Global Eye Care Progress
USAID closure leads retreat in development assistance.
Supplement: ESCRS Clinical Trends Series: Presbyopia
Nutrition and the Eye: A Recipe for Success
A look at the evidence for tasty ways of lowering risks and improving ocular health.
New Award to Encourage Research into Sustainable Practices
Sharing a Vision for the Future
ESCRS leaders update Trieste conference on ESCRS initiatives.
Extending Depth of Satisfaction
The ESCRS Eye Journal Club discuss a new study reviewing the causes and management of dissatisfaction after implantation of an EDOF IOL.
Conventional Versus Laser-Assisted Cataract Surgery
Evidence favours conventional technique in most cases.
AI Scribing and Telephone Management
Automating note-taking and call centres could boost practice efficiency.