الفهرس 
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Abstract
Iris-claw IOL was initially designed by Jan Worst in 1978 for the correction of aphakia following cataract surgery with inadequate capsular or zonular support for in the bag or sulcus placement of a conventional PC-IOL. (Worst et al., 1972) Later, the concept was modified for use in phakic eyes as a refractive procedure and the first iris-claw phakic intra-ocular lens (pIOL) was implanted by Fechner and Worst in 1986 (Fechner & Worst, 1988).
The Artisan/ Verisyse aphakia IOL design is the latest version of iris fixated intraocular lenses that is used worldwide. It is a one-piece biconvex lens made of poly-methyl methacrylate with two flexible claw haptics, which are anchored to the mid-peripheral iris to fix the lens in place (Moschos & Nitoda, 2016). This lens design has several advantages. The iris-claw IOL is placed at a safe distance from the corneal endothelium and the irido-corneal angle, reducing the risk for endothelial damage and glaucoma compared with angle-supported IOLs (Teichman & Ahmed, 2007). The technique is easier and quicker than fixating the IOL to the sclera (Jing et al., 2017). In recent years, retro-pupillary fixation of iris-claw lenses has become popular because it is implanted in a physiological and theoretically safer position, which further reduces the risk of corneal endothelial damage (Forlini et al., 2015).
This study includes evaluation of iris-claw IOL implantation. Two groups of patients were included. group I comprised patients with inadequate capsular or zonular support and they underwent iris claw aphakic intraocular lens implantation using one of two techniques: anterior chamber or retro-pupillary fixation of iris claw lens. group II comprised patients seeking refractive surgery who were not good candidates for corneal refractive surgery due to high refractive error with thin or suspicious corneas and they underwent iris claw phakic intraocular lens implantation. Eyes were evaluated for uncorrected and corrected distance visual acuity, refraction, intraocular pressure (IOP) and the incidence of postoperative complications.
In the two groups, the final postoperative uncorrected and corrected distance visual acuity improved significantly compared to preoperative values as well as the spherical equivalent of the refractive error. There was no statistically significant difference between preoperative and postoperative IOP. Postoperative complications included corneal edema, IOP elevation, inflammatory reaction, pupil ovalization, vitreous hemorrhage and lens disenclavation. There was no statistically significant difference between the two implantation positions of iris-claw aphakic IOL implantation regarding any of the studied variables.