To report the long-term outcome of the use of retropupillary implantation of the Artisan iris-claw intraocular lens (RPICIOL) in several aphakic conditions without capsular support.


This is a retrospective analysis of 320 consecutive eyes of 320 patients (222 males and 98 females) without capsular support in whom we performed RPICIOL implantation. Aphakia was associated with trauma (n=141 eyes, group 1), post-cataract surgery (n=122 eyes, group 2), and penetrating keratoplasty (57 eyes, group 3). We report the visual outcome, anatomical outcome, long-term stability of the implants, and long-term complications.


The mean patient age was 59.7 years in group 1; 60.1 years in group 2; and 65.8 years in group 3, and mean follow-up time was 5.3 years. At the end of the follow-up period, the mean post-operative best-corrected LogMAR visual acuity was 0.6 in group 1; 0.3 in group 2; and 0.6 in group 3. Complications included disenclavation of RPICIOLs (n=3), spontaneous complete posterior dislocation (n=1), retinal detachment (n=1), chronic dull pain ((n=8), severe iridodonesis (n=5) and macular oedema (n=1). There was no statistically significant reduction in the endothelial cell density at the end of the follow-up period.


Retropupillary iris-claw intraocular lens (RPICIOL) for secondary implantations in combination with transconjunctival mini invasive vitrectomy surgery is not only an effective alternative strategy to the scleral-fixed IOL, sutureless intrascleral IOL or angle supported IOL implantation, but we would consider it to be the gold standard amongst all options.

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Matteo Forlini