Ophtec Artificial Iris/Lens Prosthesis As An Alternative Treatment Of Traumatic Aniridia And Aphakia.

We report a case of traumatic aniridia, aphakia with concurrent corneal graft failure and scarring that was successfully managed with the use of the Ophtec artificial iris/lens prosthesis along with synchronous full thickness corneal transplantation.

The patient initially presented at the emergency department of the Jules Gonin Eye Hospital in Lausanne, Switzerland and was subsequently managed by the cornea service of the hospital.

A 67-year-old male patient presented to the emergency department after sustaining a right sided facial injury following a fall. A head and brain CT scan showed a ruptured right globe without any fracture. The patient’s visual acuity in the right eye was limited to hand movement. His past medical history  was significant for keratoconus treated with bilateral penetrating keratoplasty 20 years ago and of cataract surgery on the right eye a few weeks before the insult. On clinical examination, the patient presented with a deformed globe, a dehiscence of the corneal graft (12 to 9 o’clock), hyphema, aphakia and an expulsed iris. An urgent anterior vitrectomy, an anterior chamber lavage and a suturing of the detached corneal graft was performed.

Fifteen months after the insult, a combined surgical intervention was performed to address his underlying corneal graft rejection, aniridia and aphakia. During the intervention, the artificial iris prosthesis model C1 model (Ophtec B.V., Groningen, Netherlands) which includes a mounted intraocular lens was used and was fixated to the sclera. A full thickness penetrating keratoplasty was then performed. The patient reported resolution of pre-operative photosensitivity and glare, significant vision improvement and satisfaction for the cosmetic outcome. Nine months after the surgery the patient’s uncorrected visual acuity was 0.4, improved to 0.50 with a scleral contact lens.

The Ophtec Artificial Iris type C prosthesis represents a safe and efficient alternative solution in managing patients with aniridia and aphakia.  It demonstrates some advantages in comparison to other options and can be effectively combined with a full thickness corneal transplantation.