Retropupillary Artisan intraocular lens implantation in very young children with aphakia following penetrating eye injuries

Visual rehabilitation of children with penetrating eye injuries often carries a poor prognosis. When capsular support is insufficient, implantation of the aphakic Artisan (Ophtec, The Netherlands) iris-claw intraocular lens (IOL) in front of the iris is an accepted alternative to anterior chamber or scleral-fixated implantation. With anterior chamber lens implantation, however, there is concern about long-term endothelial loss. Posterior iris (or retropupillary) fixation of an Artisan IOL theoretically reduces this risk. We present three consecutive cases of penetrating eye injury resulting in aphakia successfully repaired by retropupillary implantation of the Artisan IOL. The patients achieved best-corrected visual acuities of 20/25 to 20/30 (0.10-0.15 logarithm of the minimum angle of resolution) at 8, 13, and 22 months' follow-up, respectively.