Visual outcome of intraocular Iris–Claw lens implantation in Indonesian children with ectopia lentis

PURPOSE: The purpose of the study was to describe the visual outcomes of anterior chamber iris–claw intraocular lens (IOL) implantation in pediatric ectopia lentis. MATERIALS AND METHODS: A retrospective review was conducted on the medical records of children with ectopia lentis who underwent primary anterior iris–claw IOL implantation at a national referral hospital in Indonesia in the years 2013–2020. Primary outcomes include visual acuity (VA) and postoperative complications. Postoperative data were collected at 1-year follow-up. RESULTS: A total of 26 eyes of 17 patients were included, the average age at surgery was 9 (5–14) years. Uncorrected VA significantly improved (P = 0.000) from an average of 1.6 ± 0.35 logMAR preoperatively to 0.7 ± 0.33 logMAR postoperatively, best-corrected VA also significantly improved, and 77% of eyes that achieved a postoperative best-corrected VA of 0.3 logMAR. Postoperative complications were reported in three eyes, including elevated intraocular pressure, IOL de-enclavation, severe inflammation, and endophthalmitis; all cases were promptly treated and had good visual outcomes. The mean onset of complications was roughly 3 months (77 ± 129 days) after surgery. CONCLUSION: Anterior iris–claw implantation in children with ectopia lentis appear to be effective in achieving good visual outcome. With its relatively simple technique, anterior iris–claw implantation can potentially serve as a favorable option for the treatment of pediatric ectopia lentis. Long-term prospective research with larger sample sizes is needed.