Prosthetic iris implantation for congenital, traumatic, or functional iris deficiencies

Burk, Scott; Mata, Andrea P Da; Snyder, Michael E.; Cionni, Robert J.; Cohen, John; Osher, Robert H.

doi:10.1016/s0886-3350(01)01124-5

Cited by 129 publications

(99 citation statements)

References 6 publications

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“…Various methods have been used to overcome the disabling effects of iris deficiency, including eyelid surgery, coloured contact lenses, 2,3 corneal tattooing, 4,5 and implantation of artificial irides. [6][7][8][9][10][11][12][13][14] In 1994, Sundmacher and coauthors were the first to report the use of a black iris-diaphragm posterior chamber intraocular lens (IOL) to correct congenital and traumatic aniridia. [6][7][8] These prosthetic implants have evolved over the last decade.…”

Section: Introductionmentioning

confidence: 99%

Surgical management of iris defects with prosthetic iris devices

Mavrikakis

Syam

et al. 2004

Eye

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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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Section: Introductionmentioning

confidence: 99%

Surgical management of iris defects with prosthetic iris devices

Mavrikakis

Syam

et al. 2004

Eye

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“…Prosthetic iris devices (PIDs) are used to reduce glare in congenital and acquired cases of iris deficiency. 3 We report a therapeutic use of endocapsular PID for relief of these symptoms in a patient with occludable angles following LPI.…”

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confidence: 99%

Phacoemulsification with therapeutic implantation of a prosthetic iris device following peripheral iridotomy visual complication

Beltran‐Agullo

Alaghband

Gurbaxani

et al. 2011

Eye

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;Sir, Phacoemulsification with therapeutic implantation of a prosthetic iris device following peripheral iridotomy visual complication Persistent visual disturbances occur in 2.7-7% 1,2 of patients following laser peripheral iridotomy (LPI). Prosthetic iris devices (PIDs) are used to reduce glare in congenital and acquired cases of iris deficiency. 3 We report a therapeutic use of endocapsular PID for relief of these symptoms in a patient with occludable angles following LPI.Case report A nanophthalmic, 60-year-old gentleman developed linear photopsia following LPI in his OD. Acuities were 6/60 OD and 6/6 OS. His OD was amblyopic and had early nuclear sclerosis. The LPI was covered by the superior eyelid in the primary position of gaze (Figure 1). His symptoms were exacerbated by up gaze and resolved when the superior lid was pulled downward. He could not tolerate peripheral opaque contact lenses. 4 Corneal tattooing 5 was not a viable option in the UK as sterile ink was no longer approved for human use. He agreed to undergo phacoemulsification with intraocular lens (IOL) and Morcher ring (Type 50C, Morcher GmbH, Stuttgart, Germany) implantation despite having minimal cataract with little visual improvement potential. Following a routine phacoemulsification and IOL implant, a single PID was inserted and dialled into position. Intracameral acetylcholine was injected to constrict the pupil and allow accurate placement of the opaque leaf of the ring.At 1-month follow-up, his visual acuity was 6/36 ( Figure 2) and his symptoms had completely resolved. DiscussionPersistent visual disturbances are more common when LPI is placed at the level of the upper lid margin-tear film interface. LPI should be entirely placed under the upper lid, usually at 12 o'clock, or in a fully exposed area when the lid margin is located directly at the limbus. A single PID ring was sufficient to cover the iridotomy. We had difficulties in dialling the PID accurately to cover the iridotomy despite intracameral acetylcholine. We recommend marking the site of the iridotomy at the slit-lamp before pupil dilation. In summary, the implantation of a PID is a good therapeutic alternative to tinted contact lenses, corneal tattooing, and suturing of the iridotomy in patients with glare post LPI. Conflict of interestThe authors declare no conflict of interest.

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“…[3][4][5][6][7][8][9][10] Modifications of the original iris diaphragm IOL include segmental prosthetic irises such as the Morcher 96F used in this study (Figure 1), which is a modified CTR with a single black occluder segment extending 90 degrees around the ring. 3,7,11,12 The primary advantage of this modification is that it allows for implantation through a small incision when the capsular bag is intact.…”

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confidence: 99%

“…3,7,11,12 The primary advantage of this modification is that it allows for implantation through a small incision when the capsular bag is intact. Long-term follow-up evaluating the safety and efficacy of these iris prostheses generally has been favorable, 3,5,8,[12][13][14] is currently the only surgeon in the United States who is authorized to implant these devices. The trial for use of this device was approved for 70 patients; the 70th patient was enrolled in late 2012.…”

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confidence: 99%