Surgical management of iris defects with prosthetic iris devices

PURPOSE: To evaluate the safety and efficacy of surgical implantation of prosthetic iris devices in patients with iris deficiency. METHODS: Nine patients with traumatic iris defects, congenital aniridia or iris coloboma, and surgical or optical iridectomies were included in a noncomparative case series. Cataract surgery with intraocular lens and prosthetic iris implantation was performed in 10 eyes. The visual acuity, subjective degree of glare disability, postoperative anatomic results, and intraoperative and postoperative complications were evaluated. RESULTS: The mean follow-up was 17.75 months (range 4-48 months). Best-corrected visual acuity improved in nine of 10 eyes (90%) and remained unchanged in one eye. Glare subjectively improved in four of five eyes (80%) of patients complaining of glare preoperatively. All eyes achieved the desired anatomic result. Intraoperative complications included one anterior capsular tear. Postoperative complications included a short period of mild postoperative anterior uveitis in four eyes. Secondary glaucoma was absent. CONCLUSION: In patients with iris deficiency, implantation of prosthetic iris device, and intraocular lens implant following cataract surgery appears to be safe and effective in reducing glare disability and improving visual outcomes.     

Outcomes of prosthetic iris implantation in patients with albinism

PURPOSE: To assess the safety and efficacy of implantation of prosthetic iris devices in patients with albinism. SETTING: Private practice, Cincinnati, Ohio, USA. METHODS: This retrospective noncomparative case series comprised 13 eyes of 8 patients with diminished pigment epithelium of the iris secondary to albinism. All eyes had anterior segment surgery with intraocular lens (IOL) and prosthetic iris device implantation. Eleven eyes received an endocapsular-type iris reconstruction implant (Morcher aniridia interdigitating rings), and 2 eyes (1 patient) received a combined iris-IOL device (Ophtec model 311). The visual acuity, subjective glare reduction, postoperative anatomical outcomes, and intraoperative or postoperative complications were reviewed. RESULTS: All eyes achieved the desired anatomic result. The best corrected visual acuity improved in 8 of 13 eyes, remained stable in 3 eyes, and decreased in 2 eyes. Glare and photophobia improved subjectively in 6 of 8 patients, remained unchanged in 1 patient, and increased in 1 patient after implantation of an artificial iris diaphragm. There were no intraoperative or postoperative complications. CONCLUSIONS: Implantation of prosthetic iris devices appears to be useful in the management of patients with iris deficiency secondary to albinism. The procedure was safe and particularly effective in reducing glare and photophobia in most patients.     

Implantation of iris devices in congenital and traumatic aniridias: surgery solutions and complications

PURPOSE: To show surgical solutions in patients with traumatic and congenital aniridia, to evaluate the clinical improvement of these patients when iris prosthesis are implanted, and to examine safety and complications of these implants in a long-term follow-up. METHODS: Eight patients were included in this retrospective noncomparative case series. Nine eyes had an artificial iris implantation for traumatic or congenital aniridia. Three eyes received a black diaphragm intraocular lens (IOL) in capsular bag after phacoemulsification. An aniridia prosthesis, sulcus sutured, in front of a previous IOL was implanted in two eyes. A black diaphragm IOL, sulcus sutured, in two eyes; two iris diaphragm rings, in front of the previous IOL, in one eye; and a sector iris prosthesis in front of an IOL in the last eye were implanted. Mean follow-up was 22.5 months (range 16 to 44 months). RESULTS: All patients had improved visual acuity (VA) and visual comfort after surgery. The glare disability was subjectively better in all cases. Two patients developed new ocular hypertension after surgery; one of them was controlled by medical treatment and the other needed cyclodiode. Two of the patients with glaucoma preoperatively also needed cyclodiode procedure and one of them an Ahmed valve. CONCLUSIONS: Several kinds of artificial iris implants are available. In all our patients with aniridia, iris artificial prostheses improved VA and diminished visual discomfort. Glaucoma is the most important complication after artificial iris implant. It is possible to implant the iris prosthesis in the capsular bag, but this requires a large capsulorrhexis and presents a surgical challenge.     

Aniridie-Intraokularlinsen bei Augen mit traumatischen Irisdefekten

BACKGROUND: Globe injuries frequently are the cause of permanent loss of visual function. Especially ruptures of the globe have a 50 times lower chance of achieving a final visual acuity better than 20/200 as compared to contusions of the globe. Besides injury to the retina and choroids, injury of the iris-lens diaphragm plays an important role for visual rehabilitation (10% iris defects and 1% aniridia after blunt trauma). Against this background the surgical results after implantation of aniridia intraocular lenses were investigated. PATIENTS AND METHODS: Eleven patients (41.9+/-19.6 years of age) after globe injury (three ruptures of the globe, eight penetrating injuries with trauma of the iris) were implanted with an aniridia IOL. RESULTS: The implantation of an aniridia IOL was performed on average 1.0+/-0.6 years (range: 0.4-2.3 years) after the primary injury. In ten eyes an aniridia IOL model HMK ANI 2 (Ophtec/Polytech) was implanted and in one eye an aniridia IOL model 67 (Morcher). Most patients were very satisfied with the results achieved (average corrected visual acuity 0.48; 0.05-1.0). Of the operated eyes, 63% reached a visual acuity >/=0.4. All patients noticed a significant reduction in glare disability as compared to the preoperative condition. The incidence of secondary glaucoma remained unchanged after the secondary implantation. One patient demonstrated retinal detachment 3 months after receiving the secondary implant, which was successfully treated with vitrectomy and gas tamponade. CONCLUSIONS: The implantation of aniridia IOLs seems to be a beneficial therapeutic option in post-traumatic eyes with partial or complete aniridia and aphakia with good visual recovery. During the postoperative follow-up special attention must be paid to sufficient regulation of intraocular pressure and to the retinal situation.     

Prosthetic iris devices

Congenital iris defects may usually present either as subtotal aniridia or colobomatous iris defects. Acquired iris defects are secondary to penetrating iris injury, iatrogenic after surgical excision of iris tumours, collateral trauma after anterior segment surgery, or can be postinflammatory in nature. These iris defects can cause severe visual disability in the form of glare, loss of contrast sensitivity, and loss of best corrected visual acuity. The structural loss of iris can be reconstructed with iris suturing, use of prosthetic iris implants, or by a combination of these, depending on the relative amount of residual iris stromal tissue and health of the underlying pigment epithelium. Since the first implant of a black iris diaphragm posterior chamber intraocular lens in 1994, advances in material and design technology over the last decade have led to advances in the prosthetic material, surgical technique, and instrumentation in the field of prosthetic iris implants. In this article, we review the classification of iris defects, types of iris prosthetic devices, implantation techniques, and complications.     

Black diaphragm aniridia intraocular lens for aniridia and albinism

Background Our aim was to assess the safety and efficacy of primary and secondary implantation of a black diaphragm aniridia intraocular lens (IOL) in patients that lacked a complete iris diaphragm.Methods This was a retrospective non-comparative study of six eyes in five patients with iris defects. The causes of such defects included congenital aniridia, traumatic aniridia, and oculocutaneous albinism. Three eyes underwent primary implantations of a black diaphragm IOL, and three eyes were given secondary implantations. The visual acuity, subjective severity of glare, postoperative anatomical outcome and any intraoperative or postoperative complications were reviewed.Results The mean follow-up period was 20.6 months (range 3–29 months). All patients showed stable or improvement in best-corrected visual acuity postoperatively. Glare and photophobia had improved subjectively in all patients after implantation of the black diaphragm IOL. Intraoperative complication included one case of hyphaema and iris damage during insertion of the IOL. Postoperative complications included intraocular inflammation with choroidal detachment, secondary glaucoma, and persistent epithelial defect after surgery. None of the patients developed decentration of IOL after surgery.Conclusion The black diaphragm aniridia IOL is useful in the management of the condition in patients with iris deficiency including oculocutaneous albinism. Intraoperative and postoperative complications are not uncommon, and patients should be monitored carefully in the perioperative period.     

Black diaphragm intraocular lens implantation in aphakic eyes with traumatic aniridia and previous pars plana vitrectomy

PURPOSE: To evaluate the efficacy of secondary black diaphragm intraocular lens (IOL) implantation in aphakic eyes with traumatic aniridia and previous pars plana vitrectomy (PPV). SETTING: Shandong Eye Institute and Hospital, Qingdao, China. METHODS: This retrospective study comprised 15 aphakic eyes with aniridia and no vitreous that had implantation of a secondary black diaphragm IOL 6 to 72 months after PPV. The PPV was performed as a result of trauma to the posterior segment. Before implantation of the IOL, all patients had reduced visual acuity from aphakia and intolerable glare from aniridia. Eyes were aphakic as a result of previous extracapsular cataract extraction (1 eye), lens extrusion during trauma (3 eyes), or simultaneous cataract lensectomy during PPV (11 eyes). Significant iris defects were present, with 9 eyes being aniridic after the injury. The mean follow-up was 17 months (range 3 to 34 months). The postoperative visual acuity, intra- ocular pressure (IOP), endothelial cell density, IOL centration, and intraocular inflammation were monitored. RESULTS: All 15 eyes had improved visual acuity and marked glare reduction after IOL implantation. No major IOL decentration was seen. Five patients had increased IOP 3 to 5 days after IOL implantation; 3 were known to have secondary glaucoma from trauma before surgery and their IOP was controlled preoperatively (< 21 mm Hg) with timolol 0.5% eyedrops. The other 2 patients had normal- appearing angles, and 1 was diagnosed with hemolytic glaucoma after IOL insertion. Postoperative elevated IOP was controlled by timolol eyedrops (4 eyes) or selective laser trabeculoplasty (1 eye). Hyphema was seen in 1 patient on the first day after IOL implantation, but no further bleeding was noted. Vitreous hemorrhage was seen the first day after IOL insertion in 2 patients. One resolved without sequelae; the other required vitreous washout. Retinal detachment and cystoid macular edema did not occur in any patient. CONCLUSIONS: Black diaphragm IOL implantation can be considered in eyes with coexisting aphakia and aniridia and without vitreous. Intraoperative IOP regulation is crucial in vitrectomized eyes to prevent complications such as expulsive hemorrhage. In general, visual function was better after IOL insertion as a result of better visual acuity and glare reduction. Although this IOL appears to be safe, long-term results must be assessed in studies with a longer follow-up and a larger study group.     

Endocapsular iris reconstruction implants for acquired iris defects: a clinical study

PURPOSE: To report the clinical efficacy, safety, and long-term follow-up data on the use of endocapsular iris reconstruction implants (IRIs) during cataract surgery in patients with acquired iris defects. METHODS: Single centre, retrospective, noncomparative, interventional case series. Five eyes of four patients with acquired iris defects and visually significant cataracts underwent clear cornea phacoemulsification and intraocular lens (IOL) implantation combined with insertion of endocapsular IRI. Data on the best-corrected visual acuity (BCVA), degree of preoperative and postoperative glare, photophobia, surgical complications, and long-term implant stability were analysed. Results: In all patients, IRI were successfully placed within the capsular bag during cataract surgery. There were no intraoperative or postoperative complications. Mean follow-up period was 29 months (range, 16-42). BCVA, subjective glare, and photophobia improved in all five eyes. Desired anatomic results were achieved in all of them. CONCLUSIONS: In patients with acquired iris defects, implantation of endocapsular IRI during cataract surgery appears to be a safe and effective procedure. At a mean time gate of 29 months, both IOLs and IRI appeared to remain stable within the capsular bag.     

带虹膜隔人工晶状体植入术治疗白内障合并虹膜缺损的疗效观察

目的　评价带虹膜隔人工晶状体植入术治疗白内障合并虹膜缺损的疗效 ,探讨术后并发症的发生机制。方法　收集 2 5例 (2 7只眼 )行带虹膜隔人工晶状体植入术患者 ,分析手术疗效和并发症的发生情况 ,同时应用房角镜和超声生物显微镜 (UBM)观察术后发生继发性青光眼患者的房角结构和人工晶状体襻位置。术后随访时间 3～ 18个月。结果　术后患者畏光症状明显减轻或完全消失 ;术后视力较术前提高≥ 2行 2 0只眼 (74 1% ) ,变化 <1行 5只眼 (18 5 % ) ,下降 >2行 2只眼(7 4 % )。术后并发症包括继发性青光眼 10只眼 (37 0 % )、散光度数≥ 2 0 0D 17只眼 (6 3 0 % )、角膜失代偿 2只眼 (7 4 % )、前房出血 2只眼 (7 4 % )、玻璃体出血 3只眼 (11 1% )、视网膜脱离 1只眼(3 7% )。在继发性青光眼 10只眼 2 0只人工晶状体襻中 ,9只襻准确固定在睫状沟内 ,其他位置包括前房角、睫状突及睫状突后。房角改变包括房角后退、残留虹膜根部前粘连、房角关闭。结论　带虹膜隔人工晶状体植入术可有效治疗白内障合并虹膜缺损 ;术后继发性青光眼主要与房角损伤有关 ,人工晶状体襻位置异常、眼内出血、持续性炎性反应也参与其发生。     

Secondary prosthetic iris implantation following traumatic total aniridia and pseudophakia

We present 2 pseudophakic patients who had traumatic episodes that resulted in total expulsion of the iris without disturbing the intraocular lens (IOL). Because of intolerable glare, each patient was managed by reopening the fibrosed capsular bag and implanting 2 multi-finned prosthetic iris devices through a small incision, leaving the IOL in place. Following surgery, glare was no longer present and excellent visual acuity was maintained. We believe these are the first pseudophakic patients with traumatic total aniridia to be managed by this approach.     

Visual function after implantation of aniridia intraocular lens for traumatic aniridia in vitrectomized eye

PURPOSE: To evaluate the efficacy and safety of aniridia posterior chamber intraocular lens (PCIOL) in traumatic aniridia and aphakia in vitrectomized eyes. METHODS: Four aphakic patients with traumatic aniridia and previous pars plana vitrectomy (PPV) due to posterior segment trauma enrolled in the study, and had secondary implantation of an aniridia PCIOL. Two patients were men and two women with mean age of 39.25 years. Complete ophthalmic examinations, including preoperative and postoperative visual acuity in dark and light, glare disability, visual function (using VF-9 questions modified from VF-14), stereopsis, and contrast sensitivity in 3, 6, 12, and 18 cycle per degree frequencies, were done for all patients. Postoperative intraocular pressure (IOP), IOL centration, and intraocular inflammation were monitored. Mean follow-up was 12.25 months (range 7 to 15 months). RESULTS: Visual acuity improved in all four patients, especially in the light. Glare was subjectively reduced in all of them. Stereopsis was measurable in three of them postoperatively. Contrast sensitivity improved in all patients, especially in brightness and lower frequencies. All four eyes had improved VF-9. All eyes achieved the desired anatomic results. Two cases developed elevated IOP early after surgery. In one eye, IOP elevation was transient and controlled with antiglaucoma medication, but the other eye, which had secondary glaucoma from previous trauma, required cyclophotocoagulation for the IOP to be controlled. No patient developed chronic uveitis or redetachment. CONCLUSIONS: The aniridia PCIOL can overcome aphakia, reduce glare, and increase visual function, contrast sensitivity, and stereopsis in vitrectomized eyes with traumatic aniridia. Although this kind of IOL appears safe, some disadvantages are secondary glaucoma and reduced visibility of peripheral fundus, and caution should be used in its implantation until more patients with longer follow-up are studied.     

儿童带虹膜隔人工晶状体植入术的临床应用

目的：探讨带虹膜隔人工晶状体在儿童内障术后的应用。方法：对12例（12只眼）伴无虹膜或虹膜缺损的先天性或外伤性白内障儿童施行白内障注吸术和带虹膜隔人工晶状体植入术。结果：随访平均4．33月,所有病例的视力都较术前有所改善,其中8眼（66．675）的矫正视力≥0．1,最好者达0．6。术后并发症视网膜脱离1眼,严重色素膜炎2眼,人工晶状体移位3眼。结论带虹膜隔人工晶状体植入术是儿童无虹膜或虹膜缺损眼白内障术后的一种有铲的矫正无晶状体眼的方法。     

虹膜修补瞳孔成形术的临床应用

目的探讨眼外伤或手术致虹膜损伤者进行显微虹膜修补瞳孔成形术的临床手术技巧。方法回顾性分析2010年9月至2013年10月,眼部外伤或手术致虹膜根部断离,虹膜缺损,导致瞳孔异常者施行显微虹膜修补瞳孔成形术12例（12眼）,记录患者术前、术后的视力,瞳孔形状和位置,手术并发症的发生情况。结果随访6～12个月,术后视力有不同程度提高,术后畏光和眩目等症状明显减轻,瞳孔正常生理功能恢复,未发生严重并发症。结论虹膜修补瞳孔成形术是一种比较复杂的手术,在提高患者视力的同时,能够消除畏光、眩目的症状,能最大程度地适应自然光线,提高视觉质量,改善患者外观。     

Interim results of a compassionate-use clinical trial of Morcher iris diaphragm implantation: report 1

PURPOSE: To evaluate the safety and efficacy of several different Morcher iris diaphragms in the treatment of partial or complete aniridia. SETTING: Jules Stein Eye Institute and the Department of Ophthalmology, David Geffen School of Medicine at UCLA, Los Angeles, California, USA. METHODS: This ongoing prospective single-site nonrandomized interventional clinical trial was designed to evaluate Morcher iris diaphragm models 50D, 50F, 96S, and 96F. Safety measures included changes in best corrected visual acuity (BCVA), surgical complications, adverse events, and postoperative interventions. Efficacy measures included changes in best corrected glare visual acuity and changes in daytime and nighttime glare sensitivity, measured by questionnaire responses. RESULTS: Thirteen patients (13 eyes) completed a 1-year follow-up. Regarding safety, there was a statistically significant improvement in median BCVA of 2 Snellen lines (P= .002). One patient lost 2 letters of BCVA on the 20/20 line. There were 2 adverse events. One was minor bleeding during a posterior synechialysis that resolved without intervention. The second was piggyback intraocular lens decentration from worsening zonular dialysis in an eye with a trauma history. One postoperative intervention was the repositioning of a 50D ring. Regarding efficacy, there was a statistically significant median improvement in best corrected glare acuity of 10 Snellen lines (P相似文献   

Functional and cosmetic outcomes of combined penetrating keratoplasty and iris reconstruction lens implantation in eyes with a history of trauma

PURPOSE: To determine the functional and cosmetic outcomes of combined iris reconstruction lens (Ophtec) implantation and penetrating keratoplasty (PK) in eyes with acquired partial or complete aniridia. SETTING: Jules Stein Eye Institute and the Department of Ophthalmology, David Geffen School of Medicine at UCLA, Los Angeles, California, USA. METHODS: In a prospective nonrandomized single-center interventional case series, efficacy measures included improvement in cosmesis and reduction in glare, star bursts, and photophobia. Safety measures included changes in best corrected visual acuity (BCVA), reports of adverse events, and surgical complications. RESULTS: The 9 eyes in the study had a history of penetrating or blunt trauma and were aphakic or in need of cataract surgery. Corneal pathologies necessitating transplantation included scarring, decompensation, or failure of a previous graft. Postoperatively, all patients were pleased with the cosmetic improvement of the study eye and all reported a reduction in visual disturbances. By the final follow-up examination, the BCVA improved in 4 patients but worsened in 5. Three adverse events were reported. There were no intraoperative surgical complications. The most serious postoperative complications were a pressure spike leading to loss of light perception, corneal graft rejection, and graft failure. The most common postoperative problem was surgically induced irregular corneal astigmatism. CONCLUSIONS: Ophtec iris reconstruction lens implantation and simultaneous PK reduced visual disturbances and improved the aesthetic appearance of the eyes. The long-term safety of the procedure, judged by BCVA and postoperative complications, was mixed, with both good and bad outcomes.     

Artificial iris implantation in congenital aniridia: A systematic review

Congenital aniridia is a rare, panocular disorder with a main phenotypic characteristic of a partial or complete absence of the iris existing alongside other ocular morbidities such as cataract, keratopathy, optic nerve and foveal hypoplasia, and nystagmus. The iris abnormality, however, often leads to symptoms such as photophobia, glare, and decreased visual acuity, as well as cosmetic dissatisfaction. Current management options for the iris deficit include colored iris contact lenses, corneal tattooing, and tinted contact lenses. Symptoms arising from small iris defects can be resolved with surgical management using micro-tying suture techniques such as McCannel or Siepser. Currently, larger iris defects can be treated with artificial iris implants. New prosthetic options range from colored intraocular lenses to flexible custom-made silicone iris implants. With a range of therapeutic options available and given the challenges of multiple comorbidities in aniridia, we evaluate the literature relating to the use of artificial iris implants in congenital aniridia, with a focus on the different surgical implantation techniques, the clinical outcomes achieved, complications occurred, and risk of bias of the studies included.     

Iris cerclage pupilloplasty and IOL implantation for traumatic mydriasis and aphakia after the blunt trauma of the eye

Four patients with traumatic mydriasis and aphakia following blunt injury of the eye globe were evaluated. Patients with severe glare and photophobia due to wide pupil diameter from 6.0 to 9.0 mm were managed by combined iris cerclage pupilloplasty and retropupillar iris-claw lens implantation. The postoperative anatomic results, visual acuity, subjective degree of glare, photophobia, as well as intraoperative and postoperative complications were evaluated. The mean follow-up time was 32.6 months. Best-corrected visual acuity improved in all patients from preoperative 20/60, 20/30, 20/25, 20/22 to postoperative 20/20, 20/22, 20/20, and 20/20 (Snellen charts). All eyes achieved satisfactory anatomic result with round pupil diameter 3.5–4.5 mm. Glare and photophobia disappeared in all patients. There were no intraoperative or postoperative complications. During the follow-up period, pupils remained round and iris-claw lenses well positioned, without tilting. Combined iris cerclage pupilloplasty with retropupillar iris claw lens implantation appears to be a safe and effective surgical technique in reducing pupil size and improving visual outcomes. It is also a cost- and time-effective procedure, providing great results with a single surgery.     

带虹膜隔人工晶状体在严重眼外伤中的应用价值

目的 探讨带虹膜隔人工晶状体在外伤性无虹膜无晶状体眼中的应用价值。方法 2000年4月～2003年4月应用Morcher公司生产的带虹膜隔人工晶状体治疗13例严重外伤后无虹膜无晶状体眼．均行人工晶状体二期植入术。探讨带虹膜隔人工晶状体植入术的适应证、手术方法、并发症防治及效果。结果 所有病例畏光症状改善或消失，视力均有不同程度的提高。结论 带虹膜隔人工晶状体治疗严重外伤后无虹膜眼有重要的临床意义，不仅畏光症状改善或消失，而且重建了眼前段，挽救了濒于残疾的伤眼，获得了较好的视力。     

带虹膜隔张力环植入治疗虹膜缺损

目的探讨带虹膜隔张力环植入手术治疗虹膜缺损的手术技巧、术中术后并发症。方法虹膜缺损24例（24眼）均行带虹膜张力环植入手术，分析手术操作方法、术中术后并发症及手术效果。结果根据虹膜缺损的范围和程度选择合适型号的带虹膜隔张力环。术中选择适当位置行透明角膜切口及辅助切口，前囊撕囊口应稍偏大并保证较好的连续性，防止植入过程中囊口的撕裂。部分型虹膜缺损者植入Morcher Type 96G，完全型虹膜缺损者植入2枚Morcher Type 50C。结论囊袋内植入带人工虹膜隔张力环治疗部分或完全虹膜缺损，取得了较好的治疗效果，开辟了该类疾病治疗的新思路。     

Artificial iris-lens diaphragm in reconstructive surgery for aniridia and aphakia

PURPOSE: To determine the efficacy and safety of surgical implantation of artificial iris-lens diaphragm in patients with anatomic or functional iris deficiencies, aphakia or cataract. SETTING: Svyatoslav Fyodorov MNTK Eye Microsurgery, Cheboksary, Russia. METHODS: Twenty eyes of 19 consecutive patients with combined iris and lens pathology of traumatic or congenital etiology were identified for an interventional noncomparative case series. The newly proposed model of an elastic iris-lens diaphragm with a colored haptic and additional support elements was implanted using various fixation approaches. RESULTS: Fifteen eyes (75%) experienced improvement in corrected visual acuities. The best spectacle-corrected visual acuity (BSCVA) in 2 eyes did not change, while the uncorrected visual acuity (UCVA) in these eyes increased. There were 3 eyes in which BSCVA deteriorated with no change or even slight improvement in UCVA. All patients were satisfied with the cosmetic results of the surgery and reported a decrease in glare and photophobia. There was 1 intraoperative complication of vitreous hemorrhage. Postoperatively, 2 cases of hyphema, 1 case of ciliochoroidal detachment, 4 eyes with exaggerated immediate postoperative reaction, and 1 eye with persistent low-grade cyclitis were observed. In 1 eye, there was persistent intraocular pressure rise. One eye showed signs of cystoid macular edema. No iris-lens diaphragm decentrations and no new or extensions of old retinal detachments were seen during the follow-up period. CONCLUSIONS: Artificial iris-lens diaphragm implantation effectively improved postoperative outcomes by correcting aphakia, reducing glare disability, and addressing cosmetic issues faced by iris-deficient, and aphakic or cataract patients. Although the iris-lens diaphragm appears to be safe, long-term results must be clarified in studies with longer follow-up and a larger patient population.