Surgical Outcomes of Retro-Pupillary Iris-Claw Intraocular Lens Implantation via Scleral Tunnel in Dislocated or Dropped Intraocular Lenses

Abstract

Objective: The study aimed to evaluate the clinical outcomes of scleral tunnel–assisted explantation followed by retro-pupillary iris-claw intraocular lens (RPIC-IOL) implantation in patients with dislocated or dropped intraocular lenses (IOLs).

Methods: This retrospective clinical study included 24 patients who underwent dislocated or dropped IOL extraction via a scleral tunnel, followed by RPIC-IOL implantation using the same tunnel. Preoperative and postoperative uncorrected visual acuity (UCVA), best corrected visual acuity (BCVA), intraocular pressure (IOP), and keratometric parameters were analyzed. Surgical time, complications, and follow-up duration were also recorded.

Results: Among 24 patients (mean age: 70.4 ± 13.5 years), 11 had subluxated lenses and 13 had dropped lenses. Mean UCVA improved from 1.92 ± 0.67 logarithm of the minimum angle of resolution (logMAR) preoperatively to 0.18 ± 0.11 logMAR at the final follow-up (P < .001), and mean BCVA improved from 0.99 ± 0.85 logMAR to 0.08 ± 0.10 logMAR (P < .001). The mean surgically induced astigmatism was 0.29 ± 0.51 D (P = .01). No cases of IOL dislocation were observed. Minor postoperative complications included transient IOP elevation (n = 2), limited vitreous hemorrhage (n = 1), and a single case of localized retinal detachment (n = 1). Mean surgical duration was 28.45 ± 7.47 minutes, and mean follow-up was 6.75 ± 4.08 months.

Conclusion: Scleral tunnel–assisted IOL explantation combined with RPIC-IOL implantation is a safe, effective, and sutureless technique. It provides favorable visual outcomes, minimal astigmatic changes, and a relatively short surgical time, making it a valuable alternative to scleral-fixated IOLs in the management of dislocated or dropped lenses.

Cite this article as: Kaplan FB, Küçük A, Elmas E. Surgical outcomes of retro-pupillary iris-claw intraocular lens implantation via scleral tunnel in dislocated or dropped intraocular lenses. Cerrahpaşa Med J. 2026, 50, 0007, doi: 10.5152/cjm.2026.26007