Materials and Methods: Scleral fixation of a monoblock hydrophobic acrylic IOL was performed in group 1. Monoblock polymethyl-methacrylate IOL was used as the iris-claw IOL in group 2. Pre-and postoperative best-corrected-visual acuity (BCVA), astigmatism and other findings were compared among groups.

Results: Group 1 included twenty-one patients, while group 2 eighteen. Follow-up time (months) was 10.54±4.15 (6-20) and 12.13±6.28 (6-25), in group 1 and 2, respectively. Mean age (years) was 61.81±11.48 (39-78) and 57.17±13.57 (11-78) in group 1 and 2, respectively. Preoperative BCVA (logMAR) was 0.45±0.17 (0.15-1.0) and 0.48±0.19 (0.05-1.0) in group 1 and 2, respectively. Postoperative BCVA (logMAR) was 0.37±0.18 (0.15-1.0) and 0.38±0.21 (0.15-1.0) in group 1 and 2, respectively. Preoperative mean astigmatism (diopters) was 1.75±1.21 (0.25-4.00) and 1.81±1.34 (0.25-3.75) in group 1 and 2, respectively. Postoperative mean astigmatism (diopters) was 1.79±1.29 (0.25-4.00) and 1.93±1.53 (0.25-4.25) in group 1 and 2, respectively (p=0.83). Transient postoperative intraocular pressure rise developed in two eyes and three eyes in group 1 and 2, respectively. Cystoid macular edema was observed in two eyes in each group. IOL decentralization after mydriasis occurred in three eyes and one eye in group 1 and 2, respectively.

Conclusion: Foldable scleral fixation or iris-claw IOLs are alternative treatments for aphakia in eyes without capsular support. Although the difference failed to reach a statistical significance, astigmatism was higher with iris-claw IOLs compared to astigmatism with scleral fixation IOLs. Keywords : Scleral fixation, iris-claw, intraocular lens, aphaki