IRIS PROSTHESIS (IRIS DIAPHRAGMS): MYTH AND REALITY

Abstract

SUMMARY A niridia has a great impact on the quality of life of patients, either congenital or traumatic. Aniridic patients usually have other co morbidities due to associated congenital anomalies or due to the traumatic insult in case of traumatic anirida. So, very meticulous preoperative assessment is essential before dealing with any case of anirida to avoid any intraoperative or postoperative surprise or complication that can be avoided or at least for counselling the patient about any possible complications that can be sight threating. Many options are available for treating anirida either congenital or traumatic, partial or complete. Contact lens may be the first line of treatment if the patient can tolerate it. Keratopigmentation (corneal tattooing) is another option that can be tried. Many suturing techniques are available to deal with deferent types of iris defects. Finally PID can be tried to restore the anatomy and function of the human iris following iris trauma or even with congenital iris defects. Many forms of PID are available and choice is made according to many factors including the case of anirida, degree of iris loss, integrity of lens capsule and phakic status of the patient. PID insertion is considered a challenging technique for many surgeons as it needs good surgical skills and to know how to deal with any intraoperative complications that may occur. PID serves as an effective modality in treatment of anirida. Improvement of visual acuity, glare, and cosmetic appearance have been reported and considered satisfactory for most of the patients and the surgeons. Many intraoperative and postoperative complications may take place but this can be avoided by meticulous preoperative assessment and proper choice of the suitable PID although endocapsular PID is recommended whenever possible over the sulcus or anterior chamber PID regarding lesser complications. Future studies with long term follow up is recommended to elucidate the long term complications of these devices.