J Korean Ophthalmol Soc.  2008 Feb;49(2):238-244. 10.3341/jkos.2008.49.2.238.

Black Diaphragm Intraocular Lens for Traumatic Aniridia: Long-term Follow-up

• Lee JJ
• Lee SJ
• Kim SD

• KMID: 2127114
• DOI: http://doi.org/10.3341/jkos.2008.49.2.238

Abstract

PURPOSE: This is a report on the long-term follow-up of patients who had received black diaphragm intraocular lens implantation after traumatic aniridia.
METHODS
This is a retrospective study on the long-term follow-up for more than 50 months of six patients who had received black diaphragm intraocular lens implantation after traumatic aniridia.
RESULTS
An improvement in visual acuity of more than two letters, according to the Snellan chart, occurred in three out of six eyes that were available for follow-up studies after an average period of 7 years and 8 months (50-115 months) after the operation, and no visual acuity decline groups were present. Early complications of black diaphragm intraocular lens implantation consisted of cystoid macular edema and transient intraocular pressure rise. The complications late occurred included bullous keratopathy in four eyes, glaucoma in three eyes, and exotropia in three eyes. We performed penetrating keratoplasty in two of the four eyes suffering from bullous keratopathy, and an Ahmed valve implantation in two of the three eyes suffering from glaucoma. There were signs of reduced visual acuity in four eyes due to complications of the surgery.
CONCLUSIONS
The authors of this report recommend care in use of black diaphragm intraocular lens implantation, by studies done with an average follow-up period of 7 years and 8 months post operatively. Also reported were severe complications with this treatment such as bullous keratopathy and glaucoma.

Keyword

Aniridia; Black-diaphragm IOL; Bullous keratopathy; Scleral-fixed IOL

MeSH Terms

Aniridia
Diaphragm
Exotropia
Eye
Follow-Up Studies
Glaucoma
Humans
Intraocular Pressure
Keratoplasty, Penetrating
Lens Implantation, Intraocular
Lenses, Intraocular
Macular Edema
Retrospective Studies
Stress, Psychological
Visual Acuity

Figure

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  Figure 1. Postoperative photographs. (A) Case 1; Postoperative 15 months fluorescent angiography reveal hyperfluorescent leakage at macular. (B) Case 1; After penetrating keratoplasty, slit lamp photography appearance. (C) Case 3; Last follow-up slit lamp photography appearance. Inferior corneal opacity was observed due to bullous keratopathy. (D) Case 4; Last follow-up slit lamp photography appearance of implantation of the black-diaphragm intraocular lens.

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  Figure 2. The black diaphragm IOL, type 67 G, black polymethylmethacrylate diaphragm fixed tightly to the optic zone.

Reference

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