Iris defects are associated with disabling glare and halos, poor vision, and reduced quality of life. Peter Szurman (Chief Physician, Sulzbach Eye Clinic, Germany) sees many such cases, and has often regretted the lack of an effective iris prosthesis. Has Artificial Iris addressed this need? Szurman emphasises its unique features: “Customization is so sophisticated that friends and family cannot tell that it is an implant; this cosmetic advantage is very important for aniridia patients, 95 percent of whom are young.” Intra-operative advantages include flexibility of use. “You can easily cut and shape the implant, for example in cases where only partial iris reconstruction is needed,” says Szurman.
Any advice for surgeons new to the implant? The procedure is straightforward, says Szurman. “It’s similar to trans-scleral IOL fixation, being foldable, the implant requires only a small incision. If iris remnants are present, suture-free fixation is possible; if there are neither iris remnants nor IOL, fixation requires only three sutures.” Two versions are available: a polymer-reinforced version of the prosthesis and a version without. The first better supports sutures, but the latter is more gentle and adopts better to the adjoining tissue. Most importantly, he adds, pay attention to prosthesis diameter, as an oversized iris can provoke glaucoma. “In 80 percent of cases, an 11-mm diameter iris is perfect. Only choose a 12-mm iris in very large eyes with large white-to-white distance; in small eyes, always use a 10 mm iris.”
What about outcomes? “Where damage is mainly limited to the iris, patients see big improvements, including in visual acuity. But even if VA improvements are precluded by retinal damage, patients benefit from reduced glare and improved cosmetic appearance.” And contra-indications? “Avoid silicone oil, because the prosthesis material can help oil get into the anterior chamber,” counsels Szurman.
• Customized manufacture based on photograph of fellow eye
- Iris diameter can be individually trephined per requirements
• Fabricated from pigmented silicone elastomer:
- With polymer fiber meshwork – for cases where suturing is indicated
- Without polymer fiber meshwork – for cases where suturing is not indicated
• Rapid turnaround: product delivered 6-8 weeks after order
