gms | German Medical Science

Goal: Construction of an individual injectable stenopeic membrane applicable as a prosthesis of the iris for patients with defects or absence of the iris is necessary for modern ophthalmic surgery. Implantation into the bag in combination with the IOL is seen by us the most safe alternate.

Method: During the past 10 years we have developed a system of membranes from black silicone rubber (in collaboration with ELLA-CS Company) and coloured hand painted acrylic membranes Noviris (Wilens Company, Czech Republic). After bad experiences with implantation into sulcus ciliaris we recommend implantation only into capsule with an IOL. External diameter of stenopeic membranes is 9mm, central aperture always of 4mm. Cartridge of 1,8 or 2,2mm and injectors from Medicel Co. are used. Centration of IOL behind stenopeic membrane is managed using Purkinje images. Occlusal black membrane without central aperture can be used for cosmetic or functional indication.

Results: Implants with central aperture of 4mm from black silicone rubber were used in 6 eyes. Only one star-like stenopeic membrane (external diameter of 13mm) from black silicone rubber was implanted in 1 case into sulcus ciliaris with good effect for 5 years. In the 6th year the implant was explanted because an uveal reaction probably from mechanical contact. Next 2 round formed implants (external diameter of 10mm) were used for sulcus and 3 (9mm) for the bag. Hand painted acrylic stenopeic membranes of convex profile of the same size were used in next 8 cases always implanted into the capsule. No complications were observed for 2-5 years.

Conclusion: System of coloured acrylic membranes can be optimally used for the implantation into the bag or in combination with 3-pcs IOL for scleral support.