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Simultaneous correction of post-traumatic aphakia and aniridia with the use of artificial iris and IOL implantation

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Abstract

Background

Combined post-traumatic aniridia and aphakia demand extensive and complex reconstructive surgery. We present our approach for simultaneous correction of this surgical situation with the use of the ArtificialIris (Dr. Schmidt Intraocularlinsen GmbH, Germany) with a foldable acrylic IOL Lentis L-313 (Oculentis, GmbH, Germany) sutured to its surface. The novelty (our first operation was on June 2010) of this surgical technique is based on the combined use of foldable (with closed haptics) IOL and Artificialiris to correct post-traumatic aniridia and aphakia.

Methods

Four consecutive cases of combined post-traumatic lesions of iris and lens, corrected with complex device ArtificialIris and foldable IOL. In two cases, the compound implant was sutured to the sclera in sulcus during the penetrating keratoplasty; in another case, it was positioned through a corneal incision of about 5.0 mm with transscleral fixation, and in one patient with preserved capsular support and possibility of IOL in-the-bag implantation the ArtificialIris was placed in sulcus sutureless through a clear corneal tunnel.

Results

Maximal follow-up was 6 months. The complex device was placed firmly fixed within the sulcus, including in the eye implanted without sutures, and showed a stable and centered position without any tilt or torque.

Conclusion

Management of post-traumatic aniridia combined with aphakia by haptic fixation of a foldable acrylic IOL on a foldable iris prosthesis appears to be a promising approach which gives the surgeon the possibility to correct a complex lesion with one procedure, which is less traumatic and faster. Existence of foldable materials, both iris and IOL, permits relatively small corneal incisions (4.0–5.0 mm). Moreover, the custom-tailored iris prosthesis gives a perfect aesthetic result.

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Authors and Affiliations

  1. Department of Ophthalmology, “Santa Maria Delle Croci” Hospital, Viale V. Randi n. 5-48121, Ravenna, Italy

    Cesare Forlini, Matteo Forlini, Adriana Bratu & Paolo Rossini

  2. Department of Ophthalmology, Medical University of Lublin, Chmielna 1 St, 20-079, Lublin, Poland

    Robert Rejdak & Agata Prokopiuk

  3. European Medical Center, Spiridonievsky per., 5, 123104, Moscow, Russia

    Oxana Levkina

  4. Eye Referral Center, TM Kalaw, Ermita, Manila, 1000, Philippines

    Perfecto R. Cagampang III

  5. Institute of Ophthalmology, University of Modena and Reggio Emilia, Via del Pozzo 71, 41100, Modena, Italy

    Gian Maria Cavallini

  6. Viale V. Randi n. 43-48121, Ravenna, Italy

    Cesare Forlini

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  1. Cesare Forlini
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  2. Matteo Forlini
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  3. Robert Rejdak
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  4. Agata Prokopiuk
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  5. Oxana Levkina
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  6. Adriana Bratu
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  7. Paolo Rossini
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  8. Perfecto R. Cagampang III
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  9. Gian Maria Cavallini
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Corresponding author

Correspondence to Cesare Forlini.

Additional information

The authors have no financial interest or relationship with any organization that produces any device used in this study.

The authors have full control of all primary data, and agree to allow Graefe's Archive for Clinical and Experimental Ophthalmology to review all the data upon request.

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Forlini, C., Forlini, M., Rejdak, R. et al. Simultaneous correction of post-traumatic aphakia and aniridia with the use of artificial iris and IOL implantation. Graefes Arch Clin Exp Ophthalmol 251, 667–675 (2013). https://doi.org/10.1007/s00417-012-2254-7

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  • DOI: https://doi.org/10.1007/s00417-012-2254-7

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