H-Index
17
Scimago Lab
powered by Scopus
eISSN: 1941-5923
call: +1.631.629.4328
Mon-Fri 10 am - 2 pm EST

Logo

Medical Science Monitor Basic Research
MSMbanner

Annals
ISI-Home

Get your full text copy in PDF

Traumatic Aniridia and Aphakia Management with Iris Reconstruction Lens Using Gore-Tex Sutures, an Ab-Externo Approach

Efstratios Parikakis, Georgios Batsos, Loukas Kontomichos, Vasileios Peponis, Eleni Christodoulou, Dimitrios Karagiannis

(Second Department of Ophthalmology, Ophthalmiatreio Eye Hospital of Athens, Athens, Greece)

Am J Case Rep 2020; 21:e924706

DOI: 10.12659/AJCR.924706


BACKGROUND: A safer and more delicate approach is required for the management of a post-traumatic aphakia and subtotal aniridia.
CASE REPORT: A 55-year-old man was referred to our clinic with symptoms of decreased vision (hand motion) and photophobia in his right eye. This patient had previously undergone pars plana vitrectomy (PPV) for the management of blunt ocular trauma in the same eye. He was being treated with topical antihypertensives, due to silicone oil-induced glaucoma. On presentation, the best corrected visual acuity (BCVA) in his right eye was 20/40 and the intraocular pressure (IOP) in the same eye was 20 mmHg. Slit lamp examination of his right eye showed aphakia, aniridia, and some silicone oil droplets (fish eggs) following silicone oil extraction. His corneal endothelium and thickness were within normal limits. Dilated fundoscopic examination of the right eye revealed that the retina was attached with no signs of proliferative vitreoretinopathy (PVR). An artificial iris intraocular lens (IOL) was implanted, along with 4-point scleral fixation in conjunction with Gore-Tex sutures. After 6 months, the BCVA in his right eye was 20/40 and he had no symptoms of photophobia. The IOP in that eye was 15 mmHg while on treatment with dorzolamide-timolol eye drops. No suture-related or other serious complications were observed. The patient expressed satisfaction with the functional and cosmetic results.
CONCLUSIONS: Modern vitrectomy combined with an artificial iris IOL and scleral fixation with Gore-Tex sutures in eyes lacking an iris and lens can provide long-term anatomic and functional restoration. Intraoperative IOP fluctuations and extra corneal damage can be avoided by lens preparation with the sutures using a small incision ab-externo approach.

This paper has been published under Creative Common Attribution-NonCommercial-NoDerivatives 4.0 International (CC BY-NC-ND 4.0) allowing to download articles and share them with others as long as they credit the authors and the publisher, but without permission to change them in any way or use them commercially.
I agree