Comparison of visual acuity in primary and secondary iris claw implantation in western Maharashtra

Background: A potential complication of cataract surgery is posterior capsular rent, where PCIOL can’t be implanted. Primary Iris claw implantation means that the IC-IOL is implanted in the same setting after cataract removal. While secondary Iris claw lens implant is done in an aphakic eye without capsular support and post cataract surgeries when the eye is left aphakic. Aim: To compare the visual outcome in cases of primary and secondary iris claw lens implantation after cataract surgery. This was a hospital-based Prospective Interventional Longitudinal study,conducted on patients in a tertiary care centre, in Western Maharashtra from September 2018 to August 2020. 31 eyes underwent primary iris claw implant and 19 underwent secondary iris claw implant. Results: Highly significant difference in visual acuity preoperatively due aphakia among subjects who underwent secondary iris claw implantation (p=0.000) was seen. Highly significant difference in visual acuity post operatively till 15 days was also seen due to less corneal oedema& inflammation in patients who underwent secondary iris claw implantation. No significant difference in visual acuity was seen on day 40 as lens was put in both the groups and the signs of inflammation had reduced (p=0.759). Conclusion: Overall visual outcome after 40 days is comparable in primary and secondary cases. It is better to do a primary retro fixated iris claw implantation, as in case of a secondary implant the patient will have undue anxiety, to undergo a second surgery along with increased financial burden and patient can develop complications due to aphakia. Keywords: Primary and Secondary Iris claw lens, Visual acuity, Endothelial cell count,Intra ocular pressure.