Aniridic scleral fixation of intraocular lens: The answer to vision loss with photophobia!


Journal

Indian journal of ophthalmology
ISSN: 1998-3689
Titre abrégé: Indian J Ophthalmol
Pays: India
ID NLM: 0405376

Informations de publication

Date de publication:
08 2023
Historique:
medline: 3 8 2023
pubmed: 2 8 2023
entrez: 2 8 2023
Statut: ppublish

Résumé

Aniridia is defined as missing iris tissue which can be partial, subtotal, or total. Characteristic clinical symptoms include photophobia and decreased visual acuity due to an increased light perception. In addition to this, disturbing cosmetic problems are prevalent. Even after implantation of an intraocular lens, patients often tend to be unsatisfied. The answer to this problem lies in the implantation of an aniridic scleral fixation of intraocular lens (SFIOL), which has a central optical axis that acts as the refractive lens and a peripheral rim of a hyperpigmented area that mimics the iris and hence reduces photophobia. The purpose of the video was to demonstrate the use of black diaphragm intraocular lens (BDIOL) implantation, its surgical steps, and its outcomes. We report one such case where a young patient presented with post-traumatic aniridia with subluxated total cataract and spillover vitreous hemorrhage. He was subjected to a vitrectomy, cataract removal, and placement of an aniridic SFIOL with prolene 9-0 using the four-point fixation method. This gave an extremely gratifying outcome and solved both problems, that is, vision and photophobia. Highlight: Before implantation of the SFIOL, the patients had reduced visual acuity from aphakia and intolerable glare from aniridia. In this case-based approach and with relevant example, we tried to provide a solution for tricky scenarios like co-existing traumatic cataract and traumatic aniridia. The patient showed improved visual acuity and marked glare reduction after black diaphragm SFIOL implantation. https://youtu.be/atl60WetFsM.

Sections du résumé

Background
Aniridia is defined as missing iris tissue which can be partial, subtotal, or total. Characteristic clinical symptoms include photophobia and decreased visual acuity due to an increased light perception. In addition to this, disturbing cosmetic problems are prevalent. Even after implantation of an intraocular lens, patients often tend to be unsatisfied.
Purpose
The answer to this problem lies in the implantation of an aniridic scleral fixation of intraocular lens (SFIOL), which has a central optical axis that acts as the refractive lens and a peripheral rim of a hyperpigmented area that mimics the iris and hence reduces photophobia. The purpose of the video was to demonstrate the use of black diaphragm intraocular lens (BDIOL) implantation, its surgical steps, and its outcomes.
Synopsis
We report one such case where a young patient presented with post-traumatic aniridia with subluxated total cataract and spillover vitreous hemorrhage. He was subjected to a vitrectomy, cataract removal, and placement of an aniridic SFIOL with prolene 9-0 using the four-point fixation method. This gave an extremely gratifying outcome and solved both problems, that is, vision and photophobia. Highlight: Before implantation of the SFIOL, the patients had reduced visual acuity from aphakia and intolerable glare from aniridia. In this case-based approach and with relevant example, we tried to provide a solution for tricky scenarios like co-existing traumatic cataract and traumatic aniridia. The patient showed improved visual acuity and marked glare reduction after black diaphragm SFIOL implantation.
Video link
https://youtu.be/atl60WetFsM.

Identifiants

pubmed: 37530301
pii: IndianJOphthalmol_2023_71_8_3118_382683
doi: 10.4103/IJO.IJO_775_23
pmc: PMC10538823
doi:

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

IM

Pagination

3118

Déclaration de conflit d'intérêts

None

Auteurs

Dhaivat Shah (D)

Department of Ophthalmology, Choithram Netralaya, Indore, Madhya Pradesh, India.

Rinal Pandit (R)

Department of Ophthalmology, Choithram Netralaya, Indore, Madhya Pradesh, India.

Achal Singhal (A)

Department of Ophthalmology, Choithram Netralaya, Indore, Madhya Pradesh, India.

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