Purpose To evaluate the safety and efficacy of surgical implantation of prosthetic iris devices in patients with iris deficiency. Methods Nine patients with traumatic iris defects, congenital aniridia or iris coloboma, and surgical or optical iridectomies were included in a noncomparative case series. Cataract surgery with intraocular lens and prosthetic iris implantation was performed in 10 eyes. The visual acuity, subjective degree of glare disability, postoperative anatomic results, and intraoperative and postoperative complications were evaluated. Results The mean follow-up was 17.75 months (range 4-48 months). Best-corrected visual acuity improved in nine of 10 eyes (90%) and remained unchanged in one eye. Glare subjectively improved in four of five eyes (80%) of patients complaining of glare preoperatively. All eyes achieved the desired anatomic result. Intraoperative complications included one anterior capsular tear. Postoperative complications included a short period of mild postoperative anterior uveitis in four eyes. Secondary glaucoma was absent. Conclusion In patients with iris deficiency, implantation of prosthetic iris device, and intraocular lens implant following cataract surgery appears to be safe and effective in reducing glare disability and improving visual outcomes.

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Surgeons should not be deterred from offering cataract surgery to the very elderly as successful visual rehabilitation is the norm. A further prospective multicentre study is required to confirm the benefits and assess the risks of cataract surgery in this age group.

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