June 2023
Volume 64, Issue 8
Open Access
ARVO Annual Meeting Abstract  |   June 2023
Outcome of combined cataract surgery and iris prosthesis implantation in patients with previous iris melanoma surgery
Author Affiliations & Notes
  • Jens F Kiilgaard
    Ophthalmology, Rigshospitalet, Copenhagen, Denmark
  • Kristoffer Nissen
    Ophthalmology, Rigshospitalet, Copenhagen, Denmark
  • Simon Persson Skibsted
    Ophthalmology, Rigshospitalet, Copenhagen, Denmark
  • Carsten Faber
    Ophthalmology, Rigshospitalet, Copenhagen, Denmark
  • Tine Gadegaard Gadegaard Hindsø
    Ophthalmology, Rigshospitalet, Copenhagen, Denmark
  • Per Riise
    Ophthalmology, Rigshospitalet, Copenhagen, Denmark
  • Rasmus Ejstrup
    Ophthalmology, Rigshospitalet, Copenhagen, Denmark
  • Mette Bagger
    Ophthalmology, Rigshospitalet, Copenhagen, Denmark
  • Footnotes
    Commercial Relationships   Jens Kiilgaard EURETINA, Code S (non-remunerative); Kristoffer Nissen None; Simon Skibsted None; Carsten Faber None; Tine Gadegaard Hindsø None; Per Riise None; Rasmus Ejstrup None; Mette Bagger None
  • Footnotes
    Support  None
Investigative Ophthalmology & Visual Science June 2023, Vol.64, 892. doi:
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      Jens F Kiilgaard, Kristoffer Nissen, Simon Persson Skibsted, Carsten Faber, Tine Gadegaard Gadegaard Hindsø, Per Riise, Rasmus Ejstrup, Mette Bagger; Outcome of combined cataract surgery and iris prosthesis implantation in patients with previous iris melanoma surgery. Invest. Ophthalmol. Vis. Sci. 2023;64(8):892.

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      © ARVO (1962-2015); The Authors (2016-present)

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Purpose : To examine the visual outcomes, changes in the corneal morphology, IOL tilt, changes in the intraocular pressure (IOP) and photopic patient reported symptoms after Intraocular lens (IOL) and iris prothesis (IP) in patients who had undergone Iridocyclectomy.

Methods : All treated with IOL and IP after iris melanoma surgery between 2007 and 2018 at the Copenhagen University Hospital were in cluded in the national retrospective non-comparative case series.
Patients underwent BVCA, corneal topography and keratometry, AS-OCT and PRO questionnaire regarding glare problems.

Results : A total of 46 patients were identified having anterior segment reconstruction, after iris melanoma surgery (IMS), between 2007 and 2018. One patient had only iris prothesis implantation because of IOL implantation prior to iMS, leaving 45 patients for the register study.19 patients would not participate in the invited follow up examination, resulting in 26 patients for the topography, lens tilt and questionnaire study.
5 of 45 patients developed some degree of endothalial dysfunction and 2 of the 5 patients received a DMEK. 5 of 45 patients had subluxation of the IOL/IP complex due to incomplete zonula apparatus. 22 of 45 patients showed improved BVCA, 18 patients showed no change and 5 patients decreased in BVCA after IOL/IP surgery. the 4 cases had decreased BVCA due to corneal decompensation, CSME and progression in AMD, one case could not be explained. Mean corneal astigmatism after IMS was -3.39 D
+/- 2.62 D in the operated eye and -0.90 D +/- 0.46 D in the fellow eye. The mean change in astigmatism was -0,27 D [-0,86D : +1,40D (95%CI] in operated eye (26 study eyes). 3 of 45 patients need a CL after surgery, 2 patients due to astigmatism and 1 patient due to glare caused by irregular corneal surface. 8 of 45 eyes had IOP increase that demanded IOP lowering medication, 1 patient had low IOP postoperatively.

Conclusions : Phacoemulsification with implementation of an IOL + IP is a safe procedure, but with an overall higher risk of complications compared to regular phacoemulsification procedures. A potential higher risk of posterior capsular rupture is most likely due to weakening of zonules from former IMS and due to a more demanding procedure with implementation of more material.
IMS induces a significant degree of corneal astigmatism where IOL + IP surgery induces no or minor corneal astigmatism.

This abstract was presented at the 2023 ARVO Annual Meeting, held in New Orleans, LA, April 23-27, 2023.


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