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Session Title: Complex Cases and Surgery
Session Date/Time: Monday 07/10/2013 | 14:30-16:00
Paper Time: 15:09
Venue: Forum (Ground Floor)
First Author: : B.Laptev RUSSIA
Co Author(s): : O. Fechin O. Shilovskikh Chang
To analyze remote results in patients after implantation of "Artificial iris + IOL" complex.
S. Fyodorov IRTC Eye Microsurgery, Ekaterinburg Center, Ekaterinburg, Russia
Eleven eyes of 6 patients with congenital aniridia have been operated from 2007 to 2013. There were 1 male (2 eyes) and 5 females (9 eyes) aged from 16 to 57 years (mean, 38.6). Follow-up period was from 3 to 68 months (mean, 33.6). Congenital aniridia was associated with cataract of various degree in 11 eyes, in 3 eyes of 2 patients signs of lens dislocation were see, 7 eyes of 4 patients had ptosis of the upper eyelid, and in 4 eyes there was nystagmus. Before surgery corrected visual acuity was from light perception to 0.2 (mean, 0.07). Mean IOP was 19.6 mm Hg. Endothelial cells density ranged from 2 300 to 3142 cells/mm2 (mean, 2 640). Shirmers test did not show a significant decrease of tear production (from 10 to 30 mm, mean 24.5 mm).
Corrected Visual acuity after surgery has improved in all cases and made from 0.1 to 0.6 (mean, 0.31). In 7 cases there was an IOP elevation treated medically in 6 cases and after 3 glaucoma surgeries in 1 case. The cornea was intact in 10 eyes, in 1 eye with elevated IOP there was epithelial bullous edema. Shirmers test was normal in 8 eyes, slightly decreased in 2 eyes and significantly decreased in 1 eye. All the patients use artificial tears. All the patients are satisfied with cosmetic result and mark that optical effects associated with the absence of diaphragm function of the pupil have disappeared. One female patient had uneventful pregnancy and delivered a child 60 months after the operation.
Correction of congenital aniridia with "Artificial iris + IOL" complex requires thorough preoperative examination of patients. Difficultly treated ophthalmic hypertension is a common complication. Implantation of "Artificial iris + IOL" complex is an important factor of social rehabilitation of patients.
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