Posters

Long-term results of implantation of scleral-fixated single-piece IOL and artificial iris

Poster Details

First Author: N.Silva PORTUGAL

Co Author(s):    A. Ferreira   B. Pessoa   N. Ferreira   N. Correia   M. Beirão   A. Meireles     

Abstract Details

Purpose:

Intraocular lens (IOL) and artificial iris complex implantation is appropriate to treat combined aniridia and aphakia or cataract following an ocular trauma. There are still very few studies addressing long-term results of implantation of these devices. The purpose of this study was to evaluate long-term clinical outcomes of a single-piece PMMA-based lens-and-iris diaphragm prosthesis.

Setting:

Ophthalmology Department, Centro Hospitalar Universitário do Porto

Methods:

Cross-sectional study of eyes submitted to scleral fixation of a single-piece IOL and artificial iris (Ophtec Model 311® device) following ocular trauma, with a minimum follow-up of 5 years. Ten eyes of 10 patients were included. Best-corrected visual acuity (BCVA) and intraocular pressure (IOP) were obtained in all cases. Anterior chamber volume (ACV) and depth (ACD), endothelial cell density (ECD), peripapillary retinal nerve fiber layer (RNFL) thickness and refractive error were measured when technically possible. The 25-item National Eye Institute Visual Function Questionnaire (VFQ-25) was also applied. Photograph from the affected eye was performed.

Results:

Median follow-up was 6.5 years (5-10). Six eyes were under antiglaucomatous treatment. Median BCVA was 0.7 logMAR (0.1-2.8) and IOP was 15 mmHg (11-25). Median ACV and ACD was 190 µL (144-595) and 3.8 mm (3.1-4.4), respectively, with median ECD of 2091 cells/mm2 (1311-2864). Median RNFL thickness was 95 µm (28-118). Median spherical and cylinder error was 0.75 (-1.5-6.5) and -1.5 diopters [-1.5-(-7.5)], respectively. Median VFQ-25 score was 75 (41-91). Corneal edema (n=4) was associated with higher logMAR BCVA (2.0 vs 0.5 logMAR, p=0.01) and lower VFQ-25 score (61 vs 83, p=0.01). Median RNFL thickness was negatively correlated with logMAR BCVA (r=-0.88, p=0.004).

Conclusions:

To our knowledge, this is the study that evaluated an artificial iris device implantation in traumatized eyes with the longest follow-up. The implantation of this single-piece IOL and artificial iris was associated with a good clinical outcome in terms of visual function and stability in the long-term. The refractive error was acceptable given the large corneal incision needed for its implantation. The corneal endothelial failure and secondary glaucoma were the most disabling complications.

Financial Disclosure:

None