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OBJECTIVE: To retrospectively review the safety and efficacy of black-diaphragm intraocular lenses (IOL) implanted for the treatment of post-traumatic aniridia.
METHODS: eleven patients (mean age 48 years, range 21-75) were implanted with a black-diaphragm posterior chamber IOL for correction of post-traumatic aniridia associated with cataract (4 cases)or aphakia (7 cases). All aphakic patients had reduced visual acuity and intolerable glare from aniridia. Eyes were aphakic as a result of previous extracapsular cataract extraction (3 eye), lens extrusion during trauma (3 eyes), or simultaneous cataract lensectomy during PPV (1 eyes). This IOL, in poly(methylmethacrylate), consists of an opaque diaphragm surrounding the transparent optic, and was inserted through a 10-mm scleral tunnel, and in-the-sulcus implanted(seven eyes, one is trans-sclerally sutured) or on capsular support (four eyes). The mean follow-up was 14 months (range 3 to 33 months). The postoperative visual acuity, intra- ocular pressure (IOP), endothelial cell density, IOL centration, and intraocular inflammation were monitored .
RESULTS: Best-corrected visual acuity (BCVA) improved in 10 eyes. Glare and photophobia decreased in all patients. Intraoperatively, ciliary sulcus bleeding occurred in 1 case and haptic rupture during lens insertion in one. Five patients had increased IOP 3 to 5 days after IOL implantation; Postoperative elevated IOP was controlled by timolol eyedrops. Hyphema was seen in 1 patient on the first day after IOL implantation, but no further bleeding was noted. Postoperatively, persistent intraocular inflammation was seen in 4 eyes, secondary glaucoma in 2 eyes, IOL decentration in 1, astigmatism in 10 eyes .Retinal detachment did not occur in any patient.
CONCLUSIONS: Although in our experience the haptics still seem weak and the diaphragm diameter too large, implantation of the black-diaphragm IOL appeared sufficiently safe and provided satisfactory functional results for correction of post-traumatic aniridia combined with cataract or aphakia, improving BCVA and reducing glare and photophobia in most patients, though clearly more cases and longer follow-up are needed to assess its clinical performance properly.
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