Duration 5min, Q&A 3min
The Artificial Iris-Total Iris Reconstruction Using a Personalized Artificial Iris
Complete iris loss due to trauma causes severe aesthetical limitations as well as visual impairment due to photophobia, aberration, glare effects and loss in depth of focus. We describe the use of a custom made, foldable, biocompatible, artificial iris (AI) made of silicone material which allows to exactly mimic the colour and structure of the contralateral iris and to rapidly achieve visual and cosmetic rehabilitation.
The new artificial iris (ArtificialIris, Dr. Schmidt, Germany) is fashioned by using a photograph of the contralateral iris thus ensuring appropriate colour and surface structure to become a close match to the initial appearance. The device is made of silicone elastomer similar to that of IOL's, with a thickness of 0.25 mm peripherilly and 0.40 centrally, an overall diameter of 12.80 mm and a pupil of 3.35 mm. It is available in 2 versions, ie, with or without polymer meshwork, and may be inserted into the sulcus -with or without sutures- through a 3.0 mm incision.
23 (21 male, 2 female) patients with total or partial iris loss due to trauma were included in this study. Mean age was 42y (29-62y).Minimum follow-up was 6 months (6 months to 18 months).
16 patients were aphacic without any capsular support. 10 patients had corneal scarring and underwent keratoplasty at the time of intervention. In case of aphakia, a sclerafixated intraocular lens (IOL) was implanted and the artificial iris was positioned and sutured on top of the IOL through a 3.0 mm clear corneal incision. In patients with keratoplasty, an open sky approach was chosen. In patients with capsular support the artificial iris was either implanted in the sulcus or in the bag.
Results and Conclusion
Mean preoperative best spectacle corrected visual acuity (MBSCVA) increased from 0.05 (range counting fingers to 0.2) to 0.3 (range 0.1 to 0.8) MBSCVA postoperative. Endothelial cell loss in patients without keratoplasty (n=13) was 11% in the first 6 months of follow-up. All patients were satisfied regarding the cosmetic and functional outcomes. No serious complications occured.
Up to now, iris reconstruction was a challenging surgical procedure requiring large sclero-corneal incisions with poor cosmetical outcome. With the new device small self-sealing incisions are possible enabeling fast visual recovery with excellent cosmetic outcomes. The device may be used for complete and partial iris reconstruction
[ Keyword ]
Artificial Iris / Ocular Trauma / Aniridia
[ Conflict of Interest ]