Journal List > J Korean Ophthalmol Soc > v.49(2) > 1008179

Lee, Lee, and Kim: Black Diaphragm Intraocular Lens for Traumatic Aniridia: Long-term Follow-up

Abstract

Purpose

This is a report on the long-term follow-up of patients who had received black diaphragm intraocular lens implantation after traumatic aniridia.

Methods

This is a retrospective study on the long-term follow-up for more than 50 months of six patients who had received black diaphragm intraocular lens implantation after traumatic aniridia.

Results

An improvement in visual acuity of more than two letters, according to the Snellan chart, occurred in three out of six eyes that were available for follow-up studies after an average period of 7 years and 8 months (50-115 months) after the operation, and no visual acuity decline groups were present. Early complications of black diaphragm intraocular lens implantation consisted of cystoid macular edema and transient intraocular pressure rise. The complications late occurred included bullous keratopathy in four eyes, glaucoma in three eyes, and exotropia in three eyes. We performed penetrating keratoplasty in two of the four eyes suffering from bullous keratopathy, and an Ahmed valve implantation in two of the three eyes suffering from glaucoma. There were signs of reduced visual acuity in four eyes due to complications of the surgery.

Conclusions

The authors of this report recommend care in use of black diaphragm intraocular lens implantation, by studies done with an average follow-up period of 7 years and 8 months post operatively. Also reported were severe complications with this treatment such as bullous keratopathy and glaucoma.

References

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Figure 1.
Postoperative photographs. (A) Case 1; Postoperative 15 months fluorescent angiography reveal hyperfluorescent leakage at macular. (B) Case 1; After penetrating keratoplasty, slit lamp photography appearance. (C) Case 3; Last follow-up slit lamp photography appearance. Inferior corneal opacity was observed due to bullous keratopathy. (D) Case 4; Last follow-up slit lamp photography appearance of implantation of the black-diaphragm intraocular lens.
jkos-49-238f1.tif
Figure 2.
The black diaphragm IOL, type 67 G, black polymethylmethacrylate diaphragm fixed tightly to the optic zone.
jkos-49-238f2.tif
Table 1.
Patient's data before black diaphragm IOL implantation, complications, visual acuity outcome, and follow-up periods after scleral fixed black-diaphragm IOL implantation
Patient Age /Sex Previous diagnosis Previous operation Pre-OP VA Pre-OP IOP Post-OP best VA Complication Treatment of complication Last F/U VA ( F/U period (month)
1 50/M Ruptured globe
Lens subluxation
Traumatic hyphema
ICCE
Anterior vitrectomy
0.2 15 0.4 Bullous keratopathy,
Secondary glaucoma,
Cystoid macular
edema
Penetrating keratoplasty 0.25 101
2 27/M Ruptured globe
Lens subluxation
Phacoemulsification
Anterior vitrectomy
0.6 17 0.9 Bullous keratopathy,
Secondary glaucoma
Penetrating
keratoplasty
0.075 76
3 53/F Ruptured globe
Traumatic hypema
Traumatic aphakia
A-C irrigation
Anterior vitrectomy
0.5 20 0.7 Bullous keratopathy,
Secondary glaucoma
Ahmed valve
implantation
FC
30 cm
100
4 37/M Ruptured globe
Traumatic hyphema
Traumatic cataract
Vitreous. hemorrhage
ICCE, PPV 0.4 11 0.5 Exotropia Both eye lateral
rectus mescle
recession
0.5 115
5 41/M Ruptured globe
Vitreous prolapse
PPV 0.1 16 0.1 Bullous keratopathy,
Exotropia
none NLP 51
6 16/F Ruptured globe
Traumatic cataract
Vitreous hemorrhage
Lensectomy,
Anterior vitrectomy
0.1 12-31 0.1 Exotropia Both eye lateral
rectus mescle
recession
0.1 50

OP=operation; VA=visual acuity; IOP=intraocular pressure; F/U=follow-up; FC=finger count; NLP=no light perception.

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