Long-term outcome of black diaphragm intraocular lens implantation in traumatic aniridia.

Aim

To evaluate the long-term outcome of black diaphragm intraocular (BDI) lens implantation in traumatic aniridia and investigate the possible cause of long-term complications.

Methods

Medical records of 18 patients (18 eyes), who had BDI lens implantation for traumatic aniridia at Shandong Eye Institute from January 1999 to December 2007, were retrospectively reviewed. Ultrasound biomicroscopy was used to observe the position of lens haptics. The difference between the eyes with and without long-term complications was compared.

Results

During the follow-up of 41 months (range 12-72), 12 eyes showed a satisfactory visual function, no capsule membrane was present because of pars plana vitrectomy performed before or with lens implantation, and the haptics of BDI lenses were located at the sulcus or trans-sclerally fixed. Four eyes developed refractory glaucoma at 6-36 months after the BDI lens implantation, and three of these had an intact capsule membrane, with the sulcus fixation of the lens haptics in two and trans-scleral fixation in one. Corneal decompensation occurred in six eyes, including the four with glaucoma.

Conclusions

BDI lens implantation is safe and effective in most traumatic eyes. Glaucoma and corneal decompensation appear to be the major long-term complications. The position of BDI lens is crucial for the long-term outcome.