Case Reports

Re-implantation of a combined artificial iris (AI) and intraocular lens (IOL) for traumatic mydriasis after subluxation and colour disparity: a case report

Case Report Details

First Author: M.van den Bemt THE NETHERLANDS

Co Author(s):    R. Nuijts                    

Abstract Details

Purpose:

To discuss the case of a 51-year-old man with subluxation and colour disparity of an AI. We will discuss the management of the suboptimal primary result of the AI implantation.

Setting:

University Eye Clinic Maastricht, Maastricht, the The Netherlands.

Report of Case:

A 51-year-old man was referred to us with subluxation of a sclera-fixated IOL of the left eye. In 2012, he suffered a blunt trauma of his left eye, which caused traumatic mydriasis, lens subluxation and cataract. He was treated with lens extraction, vitrectomy, a sclera-fixated IOL and iridoplasty. Over the years, he experienced several recurrent anterior chamber haemorrhages, caused by a subluxated haptic of the IOL, for which IOL exchange was indicated. In addition, he had increasing complaints of glare and photophobia due to multiple iris defects. The patient was very motivated for an AI implantation and underwent uneventful IOL explantation and implantation of an 3-P acrylic foldable IOL attached to an AI (HumanOptics) in 2019. The AI was fixated to the sclera and well-centred. Six weeks postoperatively he experienced less photophobia, however vision was decreased and the AI decentred to temporal side. In addition, the AI had a lighter colour compared to the natural (contralateral) iris. Consequently, we adjusted our ordering process for a better colour-matched AI using modified printing technology. In 2020, exchange of the AI-IOL complex took place. The surgery was uneventful. One month postoperatively, the AI and IOL are well centred and there is no colour disparity. There was no recurrence of anterior chamber haemorrhages. In addition, the patient is very satisfied with the aesthetic result and optical complaints have disappeared.

Conclusion/Take Home Message:

Colour-matching of a customized artificial iris is not flawless. Close attention to the ordering process is required to achieve a perfect aesthetic result.

Financial Disclosure:

None