A hybrid technique for management of post-traumatic aniridia and aphakia.

A hybrid technique for management of post-traumatic aniridia and aphakia.

Authors

Keywords:

Ocular trauma, Aniridia, Aphakia, Vitrectomy

Abstract

We report a case of a 35-year-old woman who suffered blunt ocular injury, causing total aniridia and aphakia associated with rhegmatogenous retinal detachment (RRD). RRD was treated with pars plana vitrectomy, a suture net with Ethilon 10-0 to prevent the silicone oil (SO) to enter the anterior chamber and SO tamponade. Implantation of a foldable prosthetic iris (Ophtec Model C) was fixed to the sclera with a hybrid technique, the Hoffmann corneoscleral pocket technique associated with Canabrava’s double flanged technique to address both pathologies of aniridia and secondary aphakia. Cosmetic result was satisfactory, patient’s visual acuity increased and no complications were observed during the follow-up. Canabrava technique simplifies and improves the fixation of the iris-intraocular lens complex to the sclera and the corneoscleral pocket technique is a safe option that does not require scleral flaps or knots, avoiding further conjunctival trauma and ensuring good stability of the implant.

References

Viestenz A, Küchle M. Blunt ocular trauma. Part I: blunt anterior segment trauma. Ophthalmologe. 2004 Dec;101(12):1239-57; quiz 1257-8;

Bord SP, Linden J. Trauma to the globe and orbit. Emerg Med Clin North Am. 2008;26(1):97-123;

Silva RS, Bruxelas CP, Andrade GC, Maia AC. A technique for the management of post-traumatic aniridia and aphakia. GMS Ophthalmol Cases. 2020; 10: Doc19;

Stem MS, Todorich B, Woodward MA, Hsu J, Wolfe JD. Scleral-fixated intraocular lenses: past and present. J Vitreoretin Dis 2017;1: 144–152;

Yamane S, Inoue M, Arakawa A, Kadonosono K. Sutureless 27-gauge needle-guided intrascleral intraocular lens implantation with lamellar scleral dissection. Ophthalmology 2014; 121: 61–66;

Spandau U, Pavlidis M. 27-Gauge Vitrectomy minimal sclerotomies for maximal results. Springer book 2015; p. 397-407;

Weissbart SB, Ayres BD. Management of aniridia and iris defects: an update on iris prosthesis options. Klin Monbl Augenheilkd. 2021 Jul;238(7):803-807;

Jakob-Girbig J, Salewsky S, Meller D. Use of the Ophtec Artificial Iris Model C1 in Patients with Aniridia/Aphakia. Klin Monbl Augenheilkd 2021 Jul;238(7):803-807;

Villemont AS, Kocaba V, Janin-Manificat H, et al. Management of post-traumatic aphakia and aniridia: Retrospective study of 17 patients undergoing scleral-sutured artificial iris intraocular lens implantation. Management of aphakia-aniridia with scleral-sutured artificial iris intraocular lenses. J Fr Ophtalmol. 2017 Sep;40(7):592-605;

Hoffman RS, Fine IH, Packer M. Scleral fixation without conjunctival dissection. J Cataract Refract Surg. 2006 Nov;32(11):1907-12;

Canabrava S., Canêdo Domingos Lima AC, Ribeiro G. Four-Flanged Intrascleral Intraocular Lens Fixation Technique: No Flaps, No Knots, No Glue. Cornea. 2020 Apr;39(4):527-528;

Canabrava S, Andrade N Jr, Henriques PR. Scleral fixation of a 4-eyelet foldable intraocular lens in patients with aphakia using a 4-flanged technique. J Cataract Refract Surg. 2021 Feb 1;47(2):265-269;

Özcan AA, Aydamırov AS. Scleral fixation of iris-Intraocular lens complex (Reper®) with Canabrava double-flanged technique: a case report. Arq Bras Oftalmol 2022 May 9; S0004-27492022005006206.

Downloads

Published

21-09-2022

How to Cite

1.
Randazzo V, Marchese V. A hybrid technique for management of post-traumatic aniridia and aphakia. Acta Biomed [Internet]. 2022 Sep. 21 [cited 2024 Jul. 18];93(S1):e2022274. Available from: https://mattioli1885journals.com/index.php/actabiomedica/article/view/13362