Clinical Results of Black-Diaphragm Intraocular Lens Implantation

PURPOSE: We studied the clinical products of sulcus fixation of Black-diaphragm intraocular lens and transscleral fixation of Black-diaphragm intraocular lens in congenital and acquired aniridia patients. METHODS: We retrospectively analyzed the records of 12 aniridic eyes in 20 patients who underwent Black-diaphragm intraocular lens implantation from December 2001 to December 2003 at our hospital. We divided the aniridia eyes into sulcus fixation (group 1, 3 eyes of 3 patients) and transscleral fixation (group 2, 8 eyes of 8 patients) groups, and congenital aniridia (group A, 3 eyes of 3 patients) and acquired anirida (group B, 9 eyes of 9 patients) groups. We compared results between groups 1 and 2, and between groups A and B. RESULTS: The differences (in diopter) between preoperatively expected refractive error and postoperative refractive error were -1.27 +/- 1.06 in group 1 and -1.06 +/- 1.06 in group 2, and this difference between groups 1 and 2 was not significant. Postoperative visual acuity results in group A (0.18 +/- 0.03) were significantly better than those in group B (0.61 +/- 0.29). CONCLUSIONS: In Black-diaphragm intraocular lens implantation of aniridia patients, the differences between preoperatively expected refractive error and postoperative refractive error were not different between sulcus fixation and transscleral fixation. Better postoperative visual acuity results are anticipated in acquired aniridia patients than in congenital aniridia patients.

Implantation of Black Diaphragm Intraocular Lens in Cataract Surgery with Congenital Aniridia

Cogenita aniridia is a relatively rare congenital anomay and its incidence is about 1:100,000. It occurs along with cataract(85%) and nystagmus(92%). Black diaphragm intraocular lenses(IOLs) were inserted in five eyes of congenital aniridia with cataract. Nystagmus was seen in all eyes, while lens subluxation was observed in two eyes. The IOLs were inserted into the ciliary sulci in two eyes with lens subluxation, and the capsular bag in three eyes. In all testing eyes, we tested preoperative and postoperative visual acuity, intraocular pressure, and preformed routine ocular examinations. We also examined multivision contrast test(MCT) in two eyes. Postoperative visual acuity improved in all cases, but the intraocular pressure increased only in one eye. The nystagmus slightly decreased in all cases. The result of postoperative MCT was the same as that of preoperative. But in the other cases, the glare decreaed. By insertion of the black diaphragm IOL, we achieved the improvement of visual acuity, the decrease of glare and nystagmus, and cosmetic effect.