BLACK DIAPHRAGM IOL IN TRAUMATIC ANIRIDIA

Purpose In this study we wanted to gain experiences with a new black d iaphragm IOL concerning surgical postoperative difficulties in traumat ic aniridia. Patients Since June 1991 we have implanted the IOL protot ype and the modifications into 13 eyes with traumatic aniridia. The IO L was transsclerally sutured in 11 eyes without capsular support and i t was positioned in front of capsular remnants in two eyes. In eight e yes penetrating keratoplasty was necessary. The mean follow-up period was 17 (1-34) months. Results The seventh IOL modification can be impl anted safely now. Persistent intraocular inflammation (Tyndall +) has been observed in all eyes postoperatively but it seems to disappear sl owly. Its effect upon the corneal endothelium and the development of c ystoid macula edema is still under investigation. Secondary glaucoma h as been the greatest postoperative problem: It could be controlled med ically in five eyes, surgically in two eyes, but remained uncontrolled in one eye. Implantation of the IOL improved visual acuity in 11/13 e yes. Conclusion Rehabilitation of eyes with traumatic aniridia by impl anting the new black diaphragm IOL still presents some unsolved proble ms, especially uncontrolled secondary glaucoma and prolonged intraocul ar inflammation. In spite of many encouraging aspects we advise to be rather cautious and self-restrictive in this group of patients.