Artificial Iris Prothesis: A Case Series Of Implantation Techniques And Outcomes

The iris plays an essential role in human vision by regulating the amount of light entering the eye. Partial or total iris defects often lead to disabling glare and photophobia as well as  decrease in visual and cosmetic appearance issues. In this study we aim to evaluate the clinical and aesthetic outcomes of surgical implantation of Artificial Iris Prosthesis in patients with acquired iris defects not suitable for suture correction alone. 

Ophthalmology Department of Hospital Prof. Doutor Fernando Fonseca, Lisboa, Portugal.

We conducted a single-center retrospective study reviewing medical records and surgical management of 5 patients who underwent implantation of artificial iris prosthesis for correction of acquired iris defects that couldn´t be treated with iris sutures. We evaluated their past ophthalmological history; preoperative and postoperative intraocular pressure (IOP) and best corrected visual acuity (BCVA) with Snellen Chart (0 to 1.0); biometry, type of prosthetic device and surgical technique. We also assessed complications during and after surgery (with time to the event and its resolution), and final cosmetic results.

​​We included 5 eyes with traumatic iris defects not suitable suture correction (mean age of 65 years and 22.6 months of follow-up). 3 eyes underwent placement of REPER with composite IOL with 3 points of scleral fixation (2 with prolene 5-0 double flanged technique(Canabrava) and 1 with prolene 10-0 scleral flaps); 1 eye received Humanoptics with sutured IOL using prolene 10-0 3-point scleral fixation with scleral flaps; and 1 eye received the Humanoptics placed in the sulcus. Intraoperative complications were mostly related to suture placement. Post-operative issues included transient IOP rise(1eye), device decentration(2 eyes) and retinal detachment(2 eyes). Mean BCVA improvement was 0.3 and cosmetic results were obtained in all of them.

This series demonstrated that the  use of artificial iris prosthesis in patients with iris defects can be a very suitable option in its surgical correction regarding visual, functional and cosmetic outcomes. However, implantation of artificial iris implies numerous challenges that are inherent to the complexity of these surgical techniques. Therefore the intra and post-operative care of an artificial iris implant should not be taken lightly and necessitates a considerable amount of surgical expertise to prevent avoidable complications.