“Double Prosthesis Implantation”: Biometry and Refractive Outcomes in Combined Intraocular Lens and Artificial Iris Surgery

Abstract

Purpose To assess the biometry and postoperative refraction in iris repair using ArtificialIris in combination with an intraocular lens (IOL). Setting Department of Ophthalmology, University Hospital Heidelberg, University of Heidelberg, Germany. Design Retrospective observational study. Methods We included 44 aniridic and aphakic eyes for IOL implantation in combination with iris prosthesis reconstruction. The iris prostheses were either sutured into the ciliary sulcus and fixed by transscleral suturing or were implanted together with a capsular tension ring and the IOL in the capsular bag. The primary outcomes measured were pre- and postoperative best corrected visual acuity (CDVA), objective and subjective refraction, anterior chamber depth and optical biometry comparing common IOL formulae. Results Reasons for surgery were trauma (39 eyes), iatrogenic causes (1 eye), aniridic state after severe iritis (2 eyes) or iris tumor (2 eyes). Monocular CDVA improved significantly (p<0.0001) from median 0.55 logMAR (0.0 to 1.98) to 0.16 logMAR (−0.08 to 2.0). There were no significant differences between the postoperative target refraction calculated by the formulae “Haigis”, “Hoffer-Q”, “SRK/T” and “Holladay 1” (p=0.68). The absolute deviation from target refraction did not differ significantly between the formulae (p=0.87). Median target refraction was −0.42 D (−4.0 to 1.68). Postoperatively median spherical equivalent was 0.00 D (−5.38 to 2.38). Median absolute deviation from target refraction after 5 months of follow-up was 0.98 D (0.06 to 5.17). Conclusion Postoperative refraction using common techniques and using preoperative biometry revealed a well predictable postoperative refraction. There is no correction factor needed.

Bilateral Artificial Iris implantation in patients with bilateral iris defects

“…Although improving CDVA is not the primary objective when implanting an Artificial Iris, it has been shown that CDVA increases in some cases, 12 , 16 , 17 , 26 including two of the cases described, which is most likely due to simultaneous cataract surgery.…”

Pupillenrekonstruktion mit einer künstlichen Iris

“…The implantation of an artificial iris is an effective option for the treatment of extensive traumatic iris defects and leads to an individual aesthetically appealing and good functional outcome as well as high patient satisfaction; however, this is an intervention that should not be underestimated because of a flat learning curve and various complications that can occur. [15,33]. Es wurde bereits in vitro an der optischen Bank (OptiSpheric IOL Pro II, Trioptics, Wedel, Deutschland) gezeigt, dass ein Annähen der IOL an die AI die optische Qualität nicht in einem relevanten Ausmaß reduziert [16].…”

Traumatische Aniridie: Konservativer oder chirurgischer Therapieansatz?

“…In der klinischen Untersuchung zeigten sich am linken Auge neben der traumatischen Mydriasis und dem Irisdefekt bei 5 bis 7 Uhr eine Hornhautnarbe der unteren Hornhauthemisphäre sowie eine traumatische Katarakt. Fundoskopisch zeigten sich links periphe- [11].…”