RESUMEN
Background: Aniridia is defined as missing iris tissue which can be partial, subtotal, or total. Characteristic clinical symptoms include photophobia and decreased visual acuity due to an increased light perception. In addition to this, disturbing cosmetic problems are prevalent. Even after implantation of an intraocular lens, patients often tend to be unsatisfied. Purpose: The answer to this problem lies in the implantation of an aniridic scleral fixation of intraocular lens (SFIOL), which has a central optical axis that acts as the refractive lens and a peripheral rim of a hyperpigmented area that mimics the iris and hence reduces photophobia. The purpose of the video was to demonstrate the use of black diaphragm intraocular lens (BDIOL) implantation, its surgical steps, and its outcomes. Synopsis: We report one such case where a young patient presented with post?traumatic aniridia with subluxated total cataract and spillover vitreous hemorrhage. He was subjected to a vitrectomy, cataract removal, and placement of an aniridic SFIOL with prolene 9?0 using the four?point fixation method. This gave an extremely gratifying outcome and solved both problems, that is, vision and photophobia. Highlight: Before implantation of the SFIOL, the patients had reduced visual acuity from aphakia and intolerable glare from aniridia. In this case?based approach and with relevant example, we tried to provide a solution for tricky scenarios like co?existing traumatic cataract and traumatic aniridia. The patient showed improved visual acuity and marked glare reduction after black diaphragm SFIOL implantation.
RESUMEN
PURPOSE: This is a report on the long-term follow-up of patients who had received black diaphragm intraocular lens implantation after traumatic aniridia. METHODS: This is a retrospective study on the long-term follow-up for more than 50 months of six patients who had received black diaphragm intraocular lens implantation after traumatic aniridia. RESULTS: An improvement in visual acuity of more than two letters, according to the Snellan chart, occurred in three out of six eyes that were available for follow-up studies after an average period of 7 years and 8 months (50-115 months) after the operation, and no visual acuity decline groups were present. Early complications of black diaphragm intraocular lens implantation consisted of cystoid macular edema and transient intraocular pressure rise. The complications late occurred included bullous keratopathy in four eyes, glaucoma in three eyes, and exotropia in three eyes. We performed penetrating keratoplasty in two of the four eyes suffering from bullous keratopathy, and an Ahmed valve implantation in two of the three eyes suffering from glaucoma. There were signs of reduced visual acuity in four eyes due to complications of the surgery. CONCLUSIONS: The authors of this report recommend care in use of black diaphragm intraocular lens implantation, by studies done with an average follow-up period of 7 years and 8 months post operatively. Also reported were severe complications with this treatment such as bullous keratopathy and glaucoma.