Artificial Iris With A Built-In Lens Implantation Combined With Penetrating Keratoplasty In A Case Of Drone Trauma

Published 2022 - 40th Congress of the ESCRS

Reference: PP08.07 | Type: Case report | DOI: 10.82333/c3k7-tz38

Authors: Augustina Grigaite* ¹ , Batis Vasileios ¹ , Theodor Stappler ¹ , Kate Hashemi ² , Yalda Sadeghi-Roulin ¹

¹Jules Gonin Eye Hospital,Lausanne,Switzerland, ²Department of Cornea and Refractive Surgery,Jules Gonin Eye Hospital,Lausanne,Switzerland

To report the use of an artificial iris prosthesis with a built-in intraocular lens in combination with penetrating keratoplasty in a case of traumatic aniridia, aphakia and corneal perforation induced by a recreational drone.

Jules Gonin Eye Hospital, Lausanne, Switzerland.

A 34-year-old male was injured by a recreational drone propeller that sliced his right eye in half. A deep penetrating horizontal corneoscleral and iris wound with expulsion of cristalline lens was detected in emergency department. The patient underwent immediate surgery and the initial wound was sutured. The patient was left aphakic. The post operative visual acuity was limited to hand movements.

One month after the injury, an exploratory vitrectomy was performed. During the surgery, suprachoroidal haemorrhage was drained and retinal detachment was repaired. Chorioretinal rupture due to sclopetary retinopathy was observed and retinectomy with endolaser retinopexy around 360° were equally performed. Silicone oil was used for tamponade. Three months later, silicone oil was removed.

Since there was an important iris defect with corneal scarring, a full thickness penetrating keratoplasty with scleral fixation of iris prosthesis was planned. A foldable acrylic hydrophobic iris prosthesis model C1 by Ophtec, which includes a mounted intraocular lens was fixated to the sclera using 3 corneoscleral Hoffman pockets. This surgery was performed 18 months after the initial traumatism. No intraoperative or immediate post-operative complications were observed. The patient is aesthetically satisfied. Current visual acuity 3 months after the procedure is 0.32 with a stenopeic hole, no signs of intraocular inflammation or graft rejection are observed.

Our case represents a successful scleral fixation of an artificial iris with a built-in IOL combined with penetrating keratoplasty in a case of complex ocular trauma. To our knowledge it's the first report of a triple procedure performed in a case of drone induced trauma. This case raises awareness about the danger of recreational drone use and its potentially devastating ocular traumatism.