Outcomes of prosthetic iris implantation in patients with albinism

Karatza, Ekaterini C.; Burk, Scott; Snyder, Michael E.; Osher, Robert H.

doi:10.1016/j.jcrs.2007.06.024

Cited by 42 publications

(26 citation statements)

References 14 publications

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“…Several studies report the outcomes of implantation of iris prosthetic IOLs, including models by Morcher GmbH 2-7 and Ophtec BV. 5,8,9 These studies report favorable results; however, some major complications, mainly the development of glaucoma, can occur. We report the outcomes in 11 eyes that had Ophtec or Morcher IOL implantation to correct iris deficiency combined with corneal transplantation.…”

Section: Resultsmentioning

confidence: 99%

Combined penetrating keratoplasty and implantation of iris prosthesis intraocular lenses after ocular trauma

Mashor

Bahar²,

Kaiserman³

et al. 2011

Journal of Cataract and Refractive Surgery

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Section: Resultsmentioning

confidence: 99%

Combined penetrating keratoplasty and implantation of iris prosthesis intraocular lenses after ocular trauma

Mashor

Bahar²,

Kaiserman³

et al. 2011

Journal of Cataract and Refractive Surgery

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“…Translucency of the hypopigmented iris is increased, and accordingly light reflection at the edge of the intraocular lens will be similarly intensified. Therefore, it is important to combine cataract surgery on OCA patients with a technique suitable to reduce transillumination of the iris [2,6]. According to relevant international literature, the following possibilities exist to reduce photophobia after cataract surgery in OCA: fitting prosthetic contact lenses, implanting iriscolored intraocular lenses, aniridia rings with special lamellae, or prosthetic iris devices.…”

Section: Discussionmentioning

confidence: 99%

Modified phacoemulsification in oculocutaneous albinism to reduce photophobia

Sohajda

Széll

Hayfron

et al. 2020

Spektrum Augenheilkd.

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Background The main ophthalmological signs of oculocutaneous albinism (OCA) are the translucency of the iris and photophobia. We describe an alternative method to reduce photophobia after cataract removal in OCA patients. Material and methods A 53-year-old woman suffered from OCA and bilateral cataract. Phacoemulsification was performed via posterior capsulorhexis with implantation of a three-piece intraocular lens into the sulcus ciliaris of the left eye and secondly of the right eye. Results We expected a fibrosis to be formed between the two capsular surfaces, which consequently would improve the diaphragm function of the iris and thus reduce photophobia. In the postoperative period, visual acuity and contrast sensitivity improved continuously, whereas photophobia decreased. Conclusion This modified surgical method is easy to perform. It is very cost-effective and can reduce photophobia and improve contrast sensitivity in albino patients in the long term.

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“…We believe that this technique is a useful option to easily fixate a subluxated iris claw AC IOL (such as the Artisan) even in challenging situations such as patients with abnormally thin or hypoplastic irises, as in connective tissue diseases such as Marfan syndrome 3,4 or Ehler-Danlos syndrome; after intraocular surgical trauma; and in situations with poor visualization of the iris through a hazy cornea. This procedure can be done with simple instrumentation.…”

Section: Discussionmentioning

confidence: 99%

“…[1][2][3] Coexisting zonular weakness is common in congenital aniridic patients with progressive zonulopathy and trauma with iris defects. Accordingly, intracapsular devices are vulnerable to late capsular bag dislocation from repeat trauma, capsule contracture, or progressive zonulysis.…”

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confidence: 99%

Capsular tension segments in repositioning capsular bag complex containing an intraocular lens and iris prosthesis

Snyder¹,

Osterholzer²

2012

Journal of Cataract and Refractive Surgery

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Placement of an iris prosthesis has been shown to reduce glare and improve visual acuity. 1-3 Coexisting zonular weakness is common in congenital aniridic patients with progressive zonulopathy and trauma with iris defects. Accordingly, intracapsular devices are vulnerable to late capsular bag dislocation from repeat trauma, capsule contracture, or progressive zonulysis. 1,4 We report what we believe is the first use of a capsular tension segment to manage late subluxation of a capsular bag complex containing a posterior chamber intraocular lens (PC IOL) and 2 iris devices. CASE REPORTA 74-year-old man was referred for a subluxated unstable capsular bag complex containing a PC IOL and 2 iris prosthetic elements. Cataract surgery had been performed previously, and 1 year after the surgery, 2 interdigitating 50c elements had been implanted in the capsular bag to control glare from traumatic aniridia.Examination showed a mobile capsular bag complex "floating" over an intact hyaloid face. A dispersive ophthalmic viscosurgical device (OVD) was injected to open the capsulorhexis margin. Two type 6D capsular tension segments (Morcher GmbH), pre-threaded with 8-0 polytetrafluoroethylene sutures (Gore-Tex, W.L. Gore & Associates, Inc.), were serially placed into opposite fornices of the capsular bag ( Figure 1). Two sets of scleral openings were created superiorly and inferiorly at the level of the ciliary sulcus. The blunt suture ends were respectively retrieved from the anterior chamber with a 23-gauge microforceps via the scleral openings and externalized. Suture tension was adjusted, recentering and stabilizing the capsular bag complex containing the IOL and iris prostheses (Figure 2). The knots and tags were rotated internally and covered by both conjunctiva and Tenon fascia.The postoperative course was unremarkable, with visual recovery to baseline and sustained significant subjective decrease in glare. DISCUSSIONA variety of techniques have been described to manage subluxated IOLs. Repositioning a capsular bag with a rigid iris prosthesis in situ can be very challenging since sutures cannot pass through rigid poly(methyl methacrylate) (PMMA) material. In addition, passing sutures through the bag between the elements could result in splitting the bag because the prosthesis prevents fusion of the anterior and posterior capsule leaflets, unlike when the bag is occupied by an IOL alone. We are aware of only 1 unreported case in which an in-the-bag PMMA iris prosthesis-IOL complex was repositioned without exchange by placing sutures directly through the acrylic optic of the IOL and then securing it to the sclera, which required considerable surgical dexterity. A In the case we describe, we were able to successfully suture refixate the bag complex using capsular tension Figure 1. Capsular tension segment is placed into the inferior capsule fornix. The white arrow shows the device sliding under the capsulorhexis margin.Figure 2. At the end of the case, the PC IOL-capsular bag-iris prosthesis complex is centered and stabl...

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Outcomes of prosthetic iris implantation in patients with albinism

Abstract: Implantation of prosthetic iris devices appears to be useful in the management of patients with iris deficiency secondary to albinism. The procedure was safe and particularly effective in reducing glare and photophobia in most patients.

Cited by 42 publications

References 14 publications

Combined penetrating keratoplasty and implantation of iris prosthesis intraocular lenses after ocular trauma

Combined penetrating keratoplasty and implantation of iris prosthesis intraocular lenses after ocular trauma

Modified phacoemulsification in oculocutaneous albinism to reduce photophobia

Capsular tension segments in repositioning capsular bag complex containing an intraocular lens and iris prosthesis

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