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Stephan L. Kaminski, Isabella Baumgartner, Christian Skorpik; Total Iris Reconstruction With a Personalized Artificial Iris. Invest. Ophthalmol. Vis. Sci. 2011;52(14):449.
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© ARVO (1962-2015); The Authors (2016-present)
Complete iris loss due to trauma causes severe aesthetical limitations as well as visual impairment due to photophobia, aberration disorders, glare effects and loss in depth of focus. We describe the use of a custom made, foldable, biocompatible, artificial iris (AI) made of silicone material which allows to exactly mimic the colour and structure of the contralateral iris and to rapidly achieve visual and cosmetic rehabilitation.
The new artificial iris (ArtificialIris, Dr. Schmidt, Germany) is fashioned by using a photograph of the contralateral iris thus ensureing approriate colour and surface structure to become a close match to the initial appearance. The device is made of silicone elastomer similar to that of IOL's, with a thickness of 0.25 mm peripherilly and 0.40 centrally, an overall diameter of 12.80 mm and a pupil of 3.35 mm. It is available in 2 versions, ie, with or without polymer meshwork, and may be inserted into the sulcus -with or without sutures- through a 2.0 mm incision. We inserted the device through self sealing clear cornea incisions with and without simultaneous phacoemulsification.
Case 1:the AI was implanted sutureless in the ciliary sulcus in a 70 yo M with complete loss of iris and a scleral fixated intraocular lens without any capsular support. Visual acuity (VA) improved from 20/100 to 20/40. Case 2: Aniridic 65 yo M with cataract had cataract removal and implantation of the AI in the capsular bag behind the IOL. VA improved from 20/200 to 20/20. Case 3: 45 yo F with traumatic aniridia and cataract had implantation of the AI sutureless in the sulcus on top of the anterior capsule after cataract removal and in the bag implantation of an IOL. VA improved from 20/200 to 20/30. Excellent cosmesis and visual quality was obtained in all cases.
Up to now, iris reconstruction was a challengeing surgical procedure requireing large sclero-corneal incisions with poor cosmetical outcome. With the new device small self-sealing incisions are possible enabeling fast visual recovery with excellent cosmetic outcomes. The device may be used for complete and partial iris reconstruction.
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