gms | German Medical Science

Background: The custom-made, flexible artificial iris developed by HumanOptics and Koch can reconstruct the anterior segment of patients with aniridia. The aim of this study was to evaluate the long-term clinical outcome and complication spectrum after artificial iris implantation.

Methods: In this retrospective interventional case series patients received an artificial iris between 2004 and 2013. Indications were congenital, traumatic or iatrogenic aniridia. The artificial iris is available with or without embedded fiber mesh for partial or full prostheses.

Results: We included 34 patients (mean age 48.8 years; SD ±17.2) with a mean follow-up of 50.0 months (SD ±18.9 months). No reposition of prostheses was necessary. In cases of keratopathy (17.6%) visual function increased from baseline mean 1.6 logMAR (SD ±0.7) to 1.2 logMAR (SD ±0.7) after artificial iris implantation. The remaining iris tissue darkened during the follow-up in 23.5%, 8.8% developed glaucoma and 14.7% needed consecutive surgery after prostheses implantation, all received an artificial iris with mesh. In 3 out of 7 trauma cases (42.9%) silicone oil was spilled into the anterior chamber after 2.5 years on average.

Conclusion: The artificial iris prosthesis revealed a good clinical outcome in terms of long-term stability, cosmetic appearance, visual function and represents a good functional iris diaphragm for compartmentalisation. Regarding complications as glaucoma, darkening of iris tissue and need for consecutive surgery, we recommend to use full iris prostheses without embedded fiber mesh, even in cases with remnant iris. Moreover, we advise to size the implant slightly smaller than originally planned.