[About Journal of Refractive Surgery ] [Table of Contents]

Volume 13 (4) * July/August 1997 * Original Article (abstract)

Traumatic Aphakia Treated with an Iris Prosthesis/Intraocular Lens or Epikeratophakia

Risto J. Uusitalo, MD; Hannu M. Uusitalo, MD

OBJECTIVE

We retrospectively analyzed the visual results and postoperative complications associated with severely traumatized eyes in which aphakia was corrected with epikeratophakia or a sutured iris prosthesis/intraocular lens (IOL).

METHODS

Fourteen eyes (14 patients) with traumatic aphakia and severe anterior segment complications were corrected either with epikeratophakia or a sutured iris prosthesis/IOL. All eyes lacked lens capsule or iris support for an IOL. The surgical technique of implanting an iris prosthesis/IOL employed transcleral suturing in the ciliary sulcus combined with penetrating keratoplasty.

RESULTS

In the eight eyes treated with epikeratophakia, four (50%) had spectacle-corrected visual acuity of 20/40 or better. Almost all of these eyes lost one or two Snellen lines of baseline spectacle-corrected visual acuity. Few complications occurred after epikeratophakia; none were severe. Of six eyes with penetrating keratoplasty and a sutured iris prosthesis/IOL or a sutured posterior chamber IOL, two (33%) achieved a visual acuity of 20/40 or better. In the IOL group, severe complications occurred, including posterior dislocation of the lens and secondary glaucoma.

CONCLUSIONS

The surgical correction of aphakia in severely traumatized eyes requires specialized surgical techniques. Epikeratophakia is a low-risk operation that can be performed in eyes in which an IOL is contraindicated. The iris prosthesis/IOL technique results in good cosmetic results; however, due to complications, this technique should be used with caution. [J Refract Surg 1997;13:382-387]

AUTHORS

From the Department of Ophthalmology, Helsinki University Central Hospital, Helsinki, Finland (R. Uusitalo) and Tampere University Hospital, Department of Ophthalmology, Tampere, Finland (H. Uusitalo).

The authors have no proprietary interest in this research.

We thank Arne Öhrström, MD, (Sweden) for design of the iris prosthesis/IOL and for valuable collaboration and consultation.

Correspondence: Risto J. Uusitalo, MD, Department of Ophthal- mology, Helsinki University Central Hospital, Haartmaninkatu 4 C, 00290 Helsinki, Finland. Fax: 358-9-4715569

Received: December 28, 1995

Accepted: January 31, 1997

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