Pars plana vitrectomy and transscleral fixation of black diaphragm intraocular lens for the management of traumatic aniridia.

Abstract

Background and objectives: Partial or complete aniridia occurring after severe ocular trauma is a difficult therapeutic problem. Diaphragm intraocular lenses were developed for the correction of aniridia, but the safety and efficacy of implanting such lenses are not well established in traumatic cases because of very few reports, and the small number of cases studied.

Patients and methods: Six patients, 4 men and 2 women with a mean age of 44 years, were treated for traumatic aniridia using pars plana vitrectomy and transscleral fixation of a black diaphragm intraocular lens. Total aniridia was observed in 3 eyes and partial aniridia in 3 eyes. Four eyes were aphakic and severe lens subluxation was seen in 2 eyes. Vitreous hemorrhage coexisted in 2 patients and bacterial endophthalmitis was present in 1 patient. Follow-up time ranged between 4 and 39 months (mean, 23 months).

Results: Best-corrected visual acuity improved in 5 patients and 1 remained unchanged. Good visual acuity (20/20 - 20/40) was achieved in all cases and all lenses were well-centered. No severe complications were noted. Three of 6 patients required glaucoma topical medications pre- and postoperatively achieving good intraocular pressure control.

Conclusion: The management of traumatic aniridia using pars plana vitrectomy and implantation of scleral fixation black diaphragm intraocular lenses seem to be safe. Very good functional results and lack of severe complications are encouraging. Additional cases with a longer follow-up study are necessary to support our opinion.