{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,26]],"date-time":"2026-02-26T19:59:15Z","timestamp":1772135955945,"version":"3.50.1"},"reference-count":33,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2021,11,2]],"date-time":"2021-11-02T00:00:00Z","timestamp":1635811200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2021,11,2]],"date-time":"2021-11-02T00:00:00Z","timestamp":1635811200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"funder":[{"DOI":"10.13039\/501100007316","name":"Klaus-Tschira-Stiftung","doi-asserted-by":"crossref","id":[{"id":"10.13039\/501100007316","id-type":"DOI","asserted-by":"crossref"}]},{"DOI":"10.13039\/501100001661","name":"Ruprecht-Karls-Universit\u00e4t Heidelberg","doi-asserted-by":"crossref","id":[{"id":"10.13039\/501100001661","id-type":"DOI","asserted-by":"crossref"}]}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Sci Rep"],"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>An Intraocular Lens (IOL) fixated on the iris either anteriorly, as a phakic IOL, or posteriorly, as an aphakic IOL, can influence pupil motility. In this interventional case series study, we evaluated pupil size under different levels of illumination (scotopic\u2009=\u20090.04\u00a0lx, low-mesopic\u2009=\u20090.4\u00a0lx and high-mesopic\u2009=\u20094\u00a0lx) for anterior iris-claw IOL fixation for correcting myopia or hyperopia (IFPH), retropupillary iris-claw IOL fixation to correct aphakia or as treatment for late in-the-bag IOL dislocation\/subluxation (IFRP), and capsular-fixation IOL in-the-bag implantation (IB). Pupil size was measured preoperatively for the IFPH- and IB-group as well as 6\u00a0months after surgery for all groups. We analyzed a total of 70 eyes: 22 eyes of 11 patients with phakic IOLs, 22 eyes of 20 patients in the IFRP group and 26 eyes of 13 patients in the IB group. Both IFPH and IB showed a smaller postoperative scotopic pupil size, compared with the preoperative values. When compared to postoperative values of IB and IFPH, IFRP showed a significantly smaller postoperative scotopic pupil size (IFPH: 5.89\u2009\u00b1\u20090.83\u00a0mm, IFRP: 4.37\u2009\u00b1\u20090.83\u00a0mm, IB: 5.34\u2009\u00b1\u20090.98\u00a0mm, p\u2009&lt;\u20090.001) while no differences were seen at high-mesopic lighting. Neither of the surgical techniques seems to impair the constriction of the pupil.<\/jats:p>","DOI":"10.1038\/s41598-021-01051-6","type":"journal-article","created":{"date-parts":[[2021,11,2]],"date-time":"2021-11-02T07:03:37Z","timestamp":1635836617000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["Pupil dynamics after in-the-bag versus anterior and retropupillary iris-fixated intraocular lens implantation"],"prefix":"10.1038","volume":"11","author":[{"given":"Yanxiu","family":"Sun","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Maximilian","family":"Hammer","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Timur M.","family":"Yildirim","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ramin","family":"Khoramnia","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Gerd U.","family":"Auffarth","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"297","published-online":{"date-parts":[[2021,11,2]]},"reference":[{"key":"1051_CR1","doi-asserted-by":"publisher","first-page":"1273","DOI":"10.1136\/bjo.2009.159871","volume":"93","author":"J-J Gicquel","year":"2009","unstructured":"Gicquel, J.-J., Langman, M. E. & Dua, H. S. Iris claw lenses in aphakia. Br. J. Ophthalmol. 93, 1273\u20131275 (2009).","journal-title":"Br. J. Ophthalmol."},{"key":"1051_CR2","doi-asserted-by":"publisher","first-page":"151","DOI":"10.1007\/BF00159844","volume":"9","author":"ES Malbran","year":"1986","unstructured":"Malbran, E. S., Malbran, E. & Negri, I. Lens guide suture for transport and fixation in secondary IOL implantation after intracapsular extraction. Int. Ophthalmol. 9, 151\u2013160 (1986).","journal-title":"Int. Ophthalmol."},{"key":"1051_CR3","doi-asserted-by":"publisher","first-page":"181","DOI":"10.3341\/kjo.2014.28.2.181","volume":"28","author":"Y-W Cho","year":"2014","unstructured":"Cho, Y.-W., Chung, I.-Y., Yoo, J.-M. & Kim, S.-J. Sutureless intrascleral pocket technique of transscleral fixation of intraocular lens in previous vitrectomized eyes. Korean J. Ophthalmol. 28, 181 (2014).","journal-title":"Korean J. Ophthalmol."},{"key":"1051_CR4","doi-asserted-by":"publisher","first-page":"326","DOI":"10.1016\/j.jcrs.2013.01.018","volume":"39","author":"A Agarwal","year":"2013","unstructured":"Agarwal, A. et al. Glued intraocular lens scaffolding to create an artificial posterior capsule for nucleus removal in eyes with posterior capsule tear and insufficient iris and sulcus support. J. Cataract Refract. Surg. 39, 326\u2013333 (2013).","journal-title":"J. Cataract Refract. Surg."},{"key":"1051_CR5","doi-asserted-by":"publisher","first-page":"161","DOI":"10.1097\/ICU.0000000000000661","volume":"31","author":"LG Patel","year":"2020","unstructured":"Patel, L. G., Starr, M. R., Ammar, M. J. & Yonekawa, Y. Scleral fixated secondary intraocular lenses: A review of recent literature. Curr. Opin. Ophthalmol. 31, 161\u2013166 (2020).","journal-title":"Curr. Opin. Ophthalmol."},{"key":"1051_CR6","doi-asserted-by":"publisher","first-page":"389","DOI":"10.1097\/ICL.0000000000000287","volume":"43","author":"R Sinha","year":"2017","unstructured":"Sinha, R. et al. Transscleral suture-fixated versus intrascleral haptic-fixated intraocular lens: A comparative study. Eye Contact Lens Sci. Clin. Pract. 43, 389\u2013393 (2017).","journal-title":"Eye Contact Lens Sci. Clin. Pract."},{"key":"1051_CR7","doi-asserted-by":"publisher","first-page":"S24","DOI":"10.1097\/IAE.0000000000002207","volume":"39","author":"P Zhao","year":"2019","unstructured":"Zhao, P., Ou, Z., Zhang, Q. & Jin, H. Adjustable buckle-slide suture: A novel surgical technique for transscleral fixation of intraocular lenses. Retina 39, S24\u2013S29 (2019).","journal-title":"Retina"},{"key":"1051_CR8","doi-asserted-by":"publisher","first-page":"580","DOI":"10.1007\/s00347-001-0563-z","volume":"99","author":"A Mohr","year":"2002","unstructured":"Mohr, A., Hengerer, F. & Eckardt, C. Retropupillare Fixation der Irisklauenlinse bei Aphakie Einjahresergebnisse einer neuen Implantationstechnik: Einjahresergebnisse einer neuen Implantationstechnik. Ophthalmologe 99, 580\u2013583 (2002).","journal-title":"Ophthalmologe"},{"key":"1051_CR9","doi-asserted-by":"publisher","first-page":"315","DOI":"10.1007\/s00347-013-2852-8","volume":"111","author":"W Sekundo","year":"2014","unstructured":"Sekundo, W., Bertelmann, T. & Schulze, S. Retropupillary iris claw intraocular lens implantation technique for aphakia. Ophthalmologe 111, 315\u2013319 (2014).","journal-title":"Ophthalmologe"},{"key":"1051_CR10","doi-asserted-by":"publisher","first-page":"618","DOI":"10.3928\/1081597X-20160601-01","volume":"32","author":"T Tandogan","year":"2016","unstructured":"Tandogan, T. et al. Material analysis of spontaneously subluxated iris-fixated phakic intraocular lenses. J. Refract. Surg. 32, 618\u2013625 (2016).","journal-title":"J. Refract. Surg."},{"key":"1051_CR11","doi-asserted-by":"publisher","first-page":"45","DOI":"10.4103\/0301-4738.178139","volume":"64","author":"S Helvaci","year":"2016","unstructured":"Helvaci, S., Demirduzen, S. & Oksuz, H. Iris-claw intraocular lens implantation: Anterior chamber versus retropupillary implantation. Indian J. Ophthalmol. 64, 45 (2016).","journal-title":"Indian J. Ophthalmol."},{"key":"1051_CR12","doi-asserted-by":"publisher","first-page":"e0214140","DOI":"10.1371\/journal.pone.0214140","volume":"14","author":"MD Toro","year":"2019","unstructured":"Toro, M. D. et al. Five-year follow-up of secondary iris-claw intraocular lens implantation for the treatment of aphakia: Anterior chamber versus retropupillary implantation. PLoS ONE 14, e0214140 (2019).","journal-title":"PLoS ONE"},{"key":"1051_CR13","doi-asserted-by":"publisher","first-page":"143","DOI":"10.1186\/s12886-015-0146-4","volume":"15","author":"M Forlini","year":"2015","unstructured":"Forlini, M. et al. Long-term follow-up of retropupillary iris-claw intraocular lens implantation: A retrospective analysis. BMC Ophthalmol. 15, 143 (2015).","journal-title":"BMC Ophthalmol."},{"key":"1051_CR14","doi-asserted-by":"publisher","first-page":"1186","DOI":"10.1016\/j.jcrs.2018.06.049","volume":"44","author":"A Hern\u00e1ndez Mart\u00ednez","year":"2018","unstructured":"Hern\u00e1ndez Mart\u00ednez, A. & Almeida Gonz\u00e1lez, C. V. Iris-claw intraocular lens implantation: Efficiency and safety according to technique. J. Cataract. Refract. Surg. 44, 1186\u20131191 (2018).","journal-title":"J. Cataract. Refract. Surg."},{"key":"1051_CR15","doi-asserted-by":"publisher","first-page":"2727","DOI":"10.2147\/OPTH.S321344","volume":"15","author":"M Thulasidas","year":"2021","unstructured":"Thulasidas, M. Retropupillary iris-claw intraocular lenses: A literature review. OPTH 15, 2727\u20132739 (2021).","journal-title":"OPTH"},{"key":"1051_CR16","doi-asserted-by":"publisher","first-page":"586","DOI":"10.1016\/j.ajo.2007.06.009","volume":"144","author":"M Baykara","year":"2007","unstructured":"Baykara, M., Ozcetin, H., Yilmaz, S. & Timu\u00e7in, \u00d6. B. Posterior iris fixation of the iris-claw intraocular lens implantation through a scleral tunnel incision. Am. J. Ophthalmol. 144, 586-591.e2 (2007).","journal-title":"Am. J. Ophthalmol."},{"key":"1051_CR17","doi-asserted-by":"publisher","first-page":"302","DOI":"10.1016\/j.jcrs.2004.04.040","volume":"31","author":"BH Dick","year":"2005","unstructured":"Dick, B. H., Aliyeva, S. & Tehrani, M. Change in pupil size after implantation of an iris-fixated toric phakic intraocular lens. J. Cataract Refract. Surg. 31, 302\u2013307 (2005).","journal-title":"J. Cataract Refract. Surg."},{"key":"1051_CR18","doi-asserted-by":"publisher","first-page":"472","DOI":"10.1007\/s00417-003-0669-x","volume":"241","author":"S Schmitz","year":"2003","unstructured":"Schmitz, S., Krummenauer, F., Henn, S. & Dick, H. B. Comparison of three different technologies for pupil diameter measurement. Graefes Arch. Clin. Exp. Ophthalmol. 241, 472\u2013477 (2003).","journal-title":"Graefes Arch. Clin. Exp. Ophthalmol."},{"key":"1051_CR19","doi-asserted-by":"publisher","first-page":"1055","DOI":"10.1007\/s003470170024","volume":"98","author":"R Maroccos","year":"2001","unstructured":"Maroccos, R., Vaz, F., Marinho, A., Guell, J. & Lohmann, C. P. Blendempfindlichkeit und Halos nach \u2018phakic IOL\u2019-Operation zur Behandlung einer hohen Myopie. Ophthalmologe 98, 1055\u20131059 (2001).","journal-title":"Ophthalmologe"},{"key":"1051_CR20","doi-asserted-by":"publisher","first-page":"e237","DOI":"10.1111\/j.1755-3768.2011.02204.x","volume":"90","author":"K Totsuka","year":"2012","unstructured":"Totsuka, K. et al. Influence of cataract surgery on pupil size in patients with diabetes mellitus. Acta Ophthalmol. 90, e237-239 (2012).","journal-title":"Acta Ophthalmol."},{"key":"1051_CR21","doi-asserted-by":"publisher","first-page":"2170","DOI":"10.1016\/S0886-3350(02)01355-X","volume":"28","author":"RJ Keuch","year":"2002","unstructured":"Keuch, R. J. & Bleckmann, H. Pupil diameter changes and reaction after posterior chamber phakic intraocular lens implantation. J. Cataract. Refract. Surg. 28, 2170\u20132172 (2002).","journal-title":"J. Cataract. Refract. Surg."},{"key":"1051_CR22","doi-asserted-by":"publisher","first-page":"796","DOI":"10.3928\/1081-597X-20071001-09","volume":"23","author":"G Sobaci","year":"2007","unstructured":"Sobaci, G., Erdem, U., Uysal, Y. & Muftuoglu, O. Changes in pupil size and centroid shift in eyes with uncomplicated in-the-bag IOL implantation. J Refract Surg 23, 796\u2013799 (2007).","journal-title":"J Refract Surg"},{"key":"1051_CR23","doi-asserted-by":"publisher","first-page":"387","DOI":"10.1159\/000306776","volume":"164","author":"JGF Worst","year":"1972","unstructured":"Worst, J. G. F., Massaro, R. G. & Ludwig, H. H. H. The introduction of an artificial lens into the eye using Binkhorst\u2019s technique (with film). Ophthalmologica 164, 387\u2013391 (1972).","journal-title":"Ophthalmologica"},{"key":"1051_CR24","doi-asserted-by":"publisher","first-page":"183","DOI":"10.1016\/S0886-3350(96)80216-1","volume":"22","author":"JJ P\u00e9rez-Santonja","year":"1996","unstructured":"P\u00e9rez-Santonja, J. J., Iradier, M. T., Ben\u00edtez del Castillo, J. M., Serrano, J. M. & Zato, M. A. Chronic subclinical inflammation in phakic eyes with intraocular lenses to correct myopia. J. Cataract. Refract. Surg. 22, 183\u2013187 (1996).","journal-title":"J. Cataract. Refract. Surg."},{"key":"1051_CR25","doi-asserted-by":"publisher","first-page":"458","DOI":"10.1016\/S0161-6420(99)90103-3","volume":"106","author":"JL Ali\u00f3","year":"1999","unstructured":"Ali\u00f3, J. L., de la Hoz, F., P\u00e9rez-Santonja, J. J., Ruiz-Moreno, J. M. & Quesada, J. A. Phakic anterior chamber lenses for the correction of myopia: A 7-year cumulative analysis of complications in 263 cases. Ophthalmology 106, 458\u2013466 (1999).","journal-title":"Ophthalmology"},{"key":"1051_CR26","doi-asserted-by":"publisher","first-page":"1288","DOI":"10.1016\/S0886-3350(00)00543-5","volume":"26","author":"JJ P\u00e9rez-Santonja","year":"2000","unstructured":"P\u00e9rez-Santonja, J. J., Ali\u00f3, J. L., Jim\u00e9nez-Alfaro, I. & Zato, M. A. Surgical correction of severe myopia with an angle-supported phakic intraocular lens. J. Cataract. Refract. Surg. 26, 1288\u20131302 (2000).","journal-title":"J. Cataract. Refract. Surg."},{"key":"1051_CR27","first-page":"1132","volume":"35","author":"B Winn","year":"1994","unstructured":"Winn, B., Whitaker, D., Elliott, D. B. & Phillips, N. J. Factors affecting light-adapted pupil size in normal human subjects. Investig. Ophthalmol. Vis. Sci. 35, 1132\u20131137 (1994).","journal-title":"Investig. Ophthalmol. Vis. Sci."},{"key":"1051_CR28","doi-asserted-by":"publisher","first-page":"134","DOI":"10.1016\/j.jcrs.2008.10.020","volume":"35","author":"K Nakamura","year":"2009","unstructured":"Nakamura, K., Bissen-Miyajima, H., Oki, S. & Onuma, K. Pupil sizes in different Japanese age groups and the implications for intraocular lens choice. J. Cataract. Refract. Surg. 35, 134\u2013138 (2009).","journal-title":"J. Cataract. Refract. Surg."},{"key":"1051_CR29","doi-asserted-by":"publisher","first-page":"549","DOI":"10.1136\/bjo.66.9.549","volume":"66","author":"YM Canavan","year":"1982","unstructured":"Canavan, Y. M. & Archer, D. B. Anterior segment consequences of blunt ocular injury. Br. J. Ophthalmol. 66, 549\u2013555 (1982).","journal-title":"Br. J. Ophthalmol."},{"key":"1051_CR30","doi-asserted-by":"publisher","first-page":"S270","DOI":"10.3928\/1081-597X-20030302-21","volume":"19","author":"Y Wang","year":"2003","unstructured":"Wang, Y., Zhao, K., Jin, Y., Niu, Y. & Zuo, T. Changes of higher order aberration with various pupil sizes in the myopic eye. J. Refract. Surg. 19, S270-274 (2003).","journal-title":"J. Refract. Surg."},{"key":"1051_CR31","doi-asserted-by":"publisher","first-page":"1211","DOI":"10.1080\/713819479","volume":"24","author":"WN Charman","year":"1977","unstructured":"Charman, W. N. & Whitefoot, H. Pupil diameter and the depth-of-field of the human eye as measured by laser speckle. Optica Acta Int. J. Opt. 24, 1211\u20131216 (1977).","journal-title":"Optica Acta Int. J. Opt."},{"key":"1051_CR32","doi-asserted-by":"publisher","first-page":"378","DOI":"10.1080\/02713680902853327","volume":"34","author":"H Hashemi","year":"2009","unstructured":"Hashemi, H. et al. Distribution of photopic pupil diameter in the Tehran eye study. Curr. Eye Res. 34, 378\u2013385 (2009).","journal-title":"Curr. Eye Res."},{"key":"1051_CR33","doi-asserted-by":"publisher","first-page":"2141","DOI":"10.2147\/OPTH.S68370","volume":"8","author":"AJ Kanellopoulos","year":"2014","unstructured":"Kanellopoulos, A. J. & Asimellis, G. Clear-cornea cataract surgery: Pupil size and shape changes, along with anterior chamber volume and depth changes. A Scheimpflug imaging study. Clin. Ophthalmol. 8, 2141\u20132150 (2014).","journal-title":"Clin. Ophthalmol."}],"container-title":["Scientific Reports"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.nature.com\/articles\/s41598-021-01051-6.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/www.nature.com\/articles\/s41598-021-01051-6","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/www.nature.com\/articles\/s41598-021-01051-6.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2022,12,3]],"date-time":"2022-12-03T11:57:21Z","timestamp":1670068641000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.nature.com\/articles\/s41598-021-01051-6"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2021,11,2]]},"references-count":33,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2021,12]]}},"alternative-id":["1051"],"URL":"https:\/\/doi.org\/10.1038\/s41598-021-01051-6","relation":{"has-review":[{"id-type":"doi","id":"10.32388\/693B3V","asserted-by":"object"}]},"ISSN":["2045-2322"],"issn-type":[{"value":"2045-2322","type":"electronic"}],"subject":[],"published":{"date-parts":[[2021,11,2]]},"assertion":[{"value":"2 July 2021","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"12 October 2021","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"2 November 2021","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"Y.Sun and M. Hammer have nothing to disclose. T. Yildirim reports non-financial support from Alcon. R. Khoramnia reports grants, personal fees and non-financial support from Alimera, Alcon, Bayer, Johnson&Johnson, Hoya, Novartis, Physiol, Rayner and Roche, grants from Chengdu Kanghong, personal fees and non-financial support from Allergan, Kowa, Oculentis\/Teleon, Oculus, Santen, and Acufocus. G. Auffarth reports grants, personal fees, non-financial support and consulting fees from Johnson&Johnson and Alcon, grants, personal fees and non-financial support from Carl Zeiss Meditec, Hoya, Kowa, Oculentis\/Teleon, Rayner, Santen, Sifi, Ursapharm, grants and personal fees from Biotech, Oculus, EyeYon, grants from Acufocus, Anew, Contamac, Glaukos, Physiol, Rheacell. All stated conflicts of interest are outside the submitted work.","order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}],"article-number":"21436"}}