{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,4]],"date-time":"2026-08-04T08:39:02Z","timestamp":1785832742298,"version":"3.56.0"},"reference-count":38,"publisher":"Wiley","issue":"6","license":[{"start":{"date-parts":[[2019,3,18]],"date-time":"2019-03-18T00:00:00Z","timestamp":1552867200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Acta Ophthalmologica"],"published-print":{"date-parts":[[2019,9]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Purpose<\/jats:title><jats:p>To compare results of sutureless transscleral intraocular lens (<jats:styled-content style=\"fixed-case\">IOL<\/jats:styled-content>) fixation to retropupillary iris\u2010claw lens implantation in cases of paediatric aphakia without capsular support.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Thirty eyes of children with insufficient capsular support for <jats:styled-content style=\"fixed-case\">IOL<\/jats:styled-content> implantation were randomized to undergo sutureless transscleral <jats:styled-content style=\"fixed-case\">IOL<\/jats:styled-content> fixation or iris\u2010claw lens fixation. The primary outcome was best\u2010corrected visual acuity (<jats:styled-content style=\"fixed-case\">BCVA<\/jats:styled-content>). Secondary outcomes included operative time, astigmatism, central corneal thickness, endothelial cell count (<jats:styled-content style=\"fixed-case\">ECC<\/jats:styled-content>), <jats:styled-content style=\"fixed-case\">IOL<\/jats:styled-content> decentration and tilt, central foveal thickness and complications.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>There was a significant improvement in <jats:styled-content style=\"fixed-case\">BCVA<\/jats:styled-content> at all follow\u2010up visits, with no significant difference between both groups. 53.3% in the <jats:italic>transscleral\u2010fixated <jats:styled-content style=\"fixed-case\">IOL<\/jats:styled-content> group<\/jats:italic> and 80% in the <jats:italic>iris\u2010claw <jats:styled-content style=\"fixed-case\">IOL<\/jats:styled-content> group<\/jats:italic> had a final <jats:styled-content style=\"fixed-case\">BCVA<\/jats:styled-content> \u22650.3. The operative time was significantly shorter in the <jats:italic>iris\u2010claw <jats:styled-content style=\"fixed-case\">IOL<\/jats:styled-content> group<\/jats:italic> (p\u00a0=\u00a00.001). <jats:styled-content style=\"fixed-case\">IOL<\/jats:styled-content> decentration and tilt were higher in the <jats:italic>transscleral\u2010fixated <jats:styled-content style=\"fixed-case\">IOL<\/jats:styled-content> group<\/jats:italic>, but the difference was not significant. The <jats:styled-content style=\"fixed-case\">ECC<\/jats:styled-content> was reduced by 14.6% in the <jats:italic>transscleral\u2010fixated <jats:styled-content style=\"fixed-case\">IOL<\/jats:styled-content> group<\/jats:italic> and 11% in the <jats:italic>iris\u2010claw group<\/jats:italic> at 6\u00a0months, with no significant difference between both groups (p\u00a0=\u00a00.5). In <jats:italic>the transscleral\u2010fixated <jats:styled-content style=\"fixed-case\">IOL<\/jats:styled-content> group<\/jats:italic>, two eyes developed ocular hypertension and two eyes had <jats:styled-content style=\"fixed-case\">IOL<\/jats:styled-content> decentration, while in the <jats:italic>iris\u2010claw <jats:styled-content style=\"fixed-case\">IOL<\/jats:styled-content> group<\/jats:italic>, 1 eye developed glaucoma, three eyes had haptic disenclavation, and one eye had retinal detachment.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Both techniques yielded a comparable visual outcome. Retropupillary iris\u2010claw lens fixation is a shorter procedure and technically easier than sutureless transscleral fixation, but the risk of disenclavation should be considered especially in younger age groups. Scleral fixation is the only option in case of severe iris damage, but may be associated with more endothelial cell loss.<\/jats:p><\/jats:sec>","DOI":"10.1111\/aos.14090","type":"journal-article","created":{"date-parts":[[2019,3,19]],"date-time":"2019-03-19T04:54:30Z","timestamp":1552971270000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":37,"title":["Transscleral sutureless intraocular lens versus retropupillary iris\u2010claw lens fixation for paediatric aphakia without capsular support: a randomized study"],"prefix":"10.1111","volume":"97","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-8468-3109","authenticated-orcid":false,"given":"Asmaa Mahmoud","family":"Shuaib","sequence":"first","affiliation":[{"name":"Department of Ophthalmology Cairo University Hospital Cairo 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