Posters

Combined artificial iris-intraocular lens implantation in traumatic aphakia-aniridia

Poster Details

First Author: I.Matias PORTUGAL

Co Author(s):    P. Gomes   S. Diniz   P. Neves   M. Ornelas   D. Martins        

Abstract Details

Purpose:

To present a case of traumatic aphakia-aniridia treated with transscleral fixation of an artificial iris-intraocular lens combined prothesis, with good functional and aesthetic result.

Setting:

Setubal Hospital Center, Portugal

Methods:

A 53 years old male with previous history of blunt trauma to his right eye causing iris expulsion, crystalline lens posterior luxation and retinal detachment. He had been submitted to pars plana vitrectomy and lensectomy, and silicone oil-tamponade. The patient complaint of low vision and photophobia. Ophthalmologic examination showed a best corrected visual acuity (with +12.0 diopters correction) of 6/10, clear cornea, deep anterior chamber, aniridia, aphakia and normal fundus under silicone oil tamponade. We decided to perform silicone oil extraction combined with implantation of an artificial iris prothesis and intraocular lens (IOL).

Results:

First we proceeded with silicone oil extraction, followed by careful inspection of the retina. Following, the artificial iris prothesis was trephined according to preoperative white-to-white measurement, a small peripheral iridectomy was performed and a 3-piece IOL was fixated to the iris prothesis. Because there was no capsular support, the artificial iris-IOL complex was secured with transscleral fixation using 10-0 polypropylene sutures at 3 equally distant positions. At one-month follow-up visual acuity was 8/10, with clear cornea and intraocular pressure was 16 mmHg. Photophobia was resolved and the patient was pleased with both the functional and cosmetic outcome.

Conclusions:

Iris defects combined with crystalline lens abnormalities are among the major complications of globe blunt trauma. Post-traumatic iris defects can cause glare, reduced contrast sensitivity, decreased vision, photophobia and cosmetic problems. When there is extensive iris damage, repair may be impossible and artificial iris implants can be used to restore iris diaphragm, reducing aniridia associated symptoms. Post-traumatic aniridia and aphakia present a surgical challenge. Combining IOL fixation on a foldable iris prosthesis allows correction of aphakia-aniridia in one procedure, through a relatively small corneal incision, with excellent aesthetic and functional outcomes.

Financial Disclosure:

None