Krishnan V Murali, Todorova Margarita G, Wiechens Burkhard, Valmaggia Christophe, Varde Meghana A
KRH Klinikum Nordstadt, Haltenhoffstrasse, Hannover, Germany; Augencenter Nüschelerstrasse, Nüschelerstrasse, Zürich; University of Basel, Petersplatz 1, Basel, Switzerland.
University of Basel, Petersplatz 1, Basel; Kantonsspital St. Gallen, St. Gallen, Switzerland.
Indian J Ophthalmol. 2021 Dec;69(12):3526-3531. doi: 10.4103/ijo.IJO_62_21.
The aim of this study is to analyze the outcome of various techniques for a custom-made iris prosthesis implantation as part of reconstructive anterior segment surgery following traumatic aniridia.
This retrospective interventional study was done for 6 eyes that received an artificial iris as secondary reconstructive measure for photophobia and unsatisfactory vision following initial globe repair. Different implantation techniques were employed. These included simple sulcus implantation, implantation of a composite (iris prosthesis with attached intraocular lens) implant, and combinations with phacoemulsification, vitrectomy, and penetrating keratoplasty.
In all cases, the artificial iris was implanted successfully. In the follow-up period (1-48 months), postoperative complications included rhegmatogenous retinal detachment, prolonged intraocular inflammation, and corneal transplant decompensation due to graft rejection. There was no case of secondary glaucoma. Complications could be managed successfully. All patients showed improved best-corrected visual acuity and were satisfied with functional and cosmetic results.
This case series highlights the different implantation techniques for reconstruction of the anterior segment after ocular trauma. The versatility of the custom-made iris implant accounts for a wide range of applications and the foldable material reduces the need for large incisions in the already traumatized eye.
本研究旨在分析作为外伤性无虹膜后重建性眼前节手术一部分的定制虹膜假体植入的各种技术的效果。
对6只眼进行了这项回顾性干预研究，这些眼接受人工虹膜作为初次眼球修复后畏光和视力不佳的二次重建措施。采用了不同的植入技术。这些技术包括单纯沟内植入、复合（带附着人工晶状体的虹膜假体）植入，以及与超声乳化、玻璃体切除术和穿透性角膜移植术的联合应用。
所有病例中，人工虹膜均成功植入。在随访期（1 - 48个月），术后并发症包括孔源性视网膜脱离、持续性眼内炎症以及因移植排斥导致的角膜移植失代偿。无继发性青光眼病例。并发症均得到成功处理。所有患者的最佳矫正视力均有提高，对功能和美容效果满意。
本病例系列突出了眼外伤后眼前节重建的不同植入技术。定制虹膜植入物的多功能性使其具有广泛的应用范围，且可折叠材料减少了在已受创伤的眼睛中做大切口的必要性。
