First Author: D.Ruiz Casas SPAIN
Co Author(s): F. Peralta Iturburu B. Gonzalo Suarez
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To describe a two-times approach for a traumatic case of giant retinal tear and detachment with a second time surgery for aniridia and aphakia using a foldable intraocular lens (IOL)- iris prosthesis using a regular IOL injector.
Hospital Ramón y Cajal (Madrid), Spain
A 76 year-old man was referred for surgical correction of giant retinal tear/ detachment, aniridia and aphakia after trauma. Visual acuity (VA) was hand movement on RE. First surgery was pars plana vitrectomy, internal limiting membrane (ILM) peeling, laser retinopexy and long-acting gas tamponade. After 8 months, second time surgery for implantation of iris prosthesis using two scleral flaps and tunnels was performed. A foldable iris prosthesis was cutted using white-to-white measurement. A 3-pieces IOL was sutured to the iris implant and was introduced through a regular IOL inyector using a 4 mm clear corneal incision.
After 3 months of the last surgery BCVA was 20/70. Also, photophobia was significaly reduced after iris implant and the aesthetical appereance of the eye showed improvement. The satistaction of the patient was optimal. There were no complications in the post-operative time, with a steady iol-artificial iris.
The two-times approach of this trauma case provided to the patient an optimal and satisfactory result. The retinal detachment surgery with ilm-peeling and long-acting gas tamponade for the first surgery with a second time implantation of a foldable IOL-iris prosthesis to address aphakia and aniridia, was the right way in our patient. The use of a foldable iris prosthesis allowed the implantation through a corneal incision of 4 mm, as not is the case if a non-foldable prosthesis was used requiring an 8.0 mm main incision. This technique also provided an optimal aesthetical result.