Purpose To determine the functional and cosmetic outcomes of Ophtec iris reconstruction lens implantation, and simultaneous penetrating keratoplasty in eyes with acquired partial or complete aniridia.
Setting Jules Stein Eye Institute and the Department of Ophthalmology, David Geffen School of Medicine at UCLA, Los Angeles, California.
Methods This was a prospective, nonrandomized, single-center, interventional case series. Efficacy measures included improvement in cosmesis and reduction in glare, starbursts, and photophobia. Safety measures included changes in best-corrected visual acuity (BCVA), reports of adverse events, and surgical complications.
Results The nine study eyes had a history of penetrating or blunt trauma and were aphakic or in need of cataract surgery. Corneal pathologies necessitating transplantation included scarring, decompensation, or failure of a previous graft. Postoperatively, all patients were pleased with the cosmetic improvement of the study eye and all patients reported a reduction in visual disturbances. By the final follow-up examination, BCVA improved in four patients but worsened in five. Three adverse events were reported. There were no intraoperative surgical complications. The three most serious postoperative complications were a pressure spike leading to loss of light perception, corneal graft rejection, and graft failure. The most common postoperative problem was surgically induced irregular corneal astigmatism.
Conclusions Ophtec iris reconstruction lens implantation and simultaneous penetrating keratoplasty reduced visual disturbances and improved the aesthetic appearance of the study eyes. The long-term safety of the procedure, as judged by BCVA and postoperative complications, was mixed, with good and bad outcomes.
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