Management Of Aniridia And Cataract With Intraocular Lens Implantation And Sulcus-Fixated Reper Aniridia Prosthesis: A Case Report

To present a case of bilateral aniridia and cataract treated with phacoemulsification, in-the-bag intraocular lens (IOL) implantation, and sulcus-fixated Reper aniridia prosthesis. This report evaluates the surgical technique, anatomical outcomes, and postoperative visual improvement.

This case was managed at a specialized ophthalmic surgical center. The procedure was performed under standard operating room conditions, utilizing phacoemulsification with an in-the-bag IOL implantation, followed by Reper aniridia prosthesis insertion into the sulcus without sutures. Pre- and postoperative evaluations included visual acuity, anterior segment OCT, and slit-lamp biomicroscopy.

A 45-year-old patient with bilateral congenital aniridia and cataracts presented with progressive visual impairment. Preoperative visual acuity was 0.02 in both eyes. Comprehensive ophthalmologic examination, including anterior segment OCT and corneal topography, was performed; however, nystagmus limited test reliability.

Surgery was performed under topical anesthesia using a standard phacoemulsification technique. A posterior chamber IOL was implanted in the capsular bag. The main incision was then enlarged to 3.5 mm, and the Reper aniridia prosthesis was inserted into the sulcus using Kelman forceps. No additional sutures were used, and corneal suturing was performed to secure the wound.

The postoperative course was uneventful, and at one month, the patient’s visual acuity improved to 0.3 in both eyes. OCT imaging confirmed the prosthesis had a concave profile, with the artificial pupil in contact with the IOL and its peripheral edges positioned within the sulcus without direct contact with the residual iris tissue. The patient reported improved photophobia and functional vision.

This case demonstrates that sulcus fixation of an aniridia prosthesis without sutures provides stable anatomical integration, avoids intraoperative complexity, and improves postoperative visual function

Sulcus fixation of the Reper aniridia prosthesis without sutures is a safe and effective alternative to conventional in-the-bag or suture-fixated approaches. This technique reduces surgical complexity, maintains prosthesis stability, and results in significant visual improvement. Postoperative imaging confirmed optimal anatomical integration with no direct contact between the prosthesis and residual iris tissue, reducing the risk of inflammation or mechanical issues. The absence of intraoperative and postoperative complications supports this approach. While long-term outcomes remain to be studied, this case suggests sulcus fixation without sutures may provide a simpler and equally effective alternative to traditional techniques.