Results in combined cataract surgery with prosthetic iris implantation in patients with previous iridocyclectomy for iris melanoma

• Published in: American journal of ophthalmology 2017-03, Vol.175, p.45-51
• Main Authors: Snyder, Michael E, Osher, Robert H, Wladecki, Trisha M, Perez, Mauricio A, Augsburger, James J, Corrêa, Zélia
• Format: Article
• Language: English
• Subjects: Aged; Aged, 80 and over; Cataract - complications; Cataract Extraction - methods; Cataracts; Defects; Eye surgery; Female; Follow-Up Studies; Humans; Iridectomy - methods; Iris - surgery; Iris Neoplasms - complications; Iris Neoplasms - diagnosis; Iris Neoplasms - surgery; Melanoma; Melanoma - complications; Melanoma - diagnosis; Melanoma - surgery; Middle Aged; Ophthalmology; Patients; Polymethyl methacrylate; Prostheses; Prosthesis Design; Prosthesis Implantation - methods; Retrospective Studies; Skin cancer; Transplants & implants; Treatment Outcome; Visual Acuity
• ISSN: 0002-9394; 1879-1891
• DOI: 10.1016/j.ajo.2016.11.013

Purpose To present visual and functional results following implantation of iris prosthesis combined with cataract surgery in eyes with previous iridocyclectomy for iris melanoma or presumed iris melanoma. Design Retrospective non-comparative case series Methods Sixteen patients (16 eyes) with iris defects after iridocyclectomy for iris melanoma in 15 cases and iris adenoma in 1 case underwent prosthetic iris device implantation surgery. Prosthetic iris implantation was combined with phacoemulsification and intraocular lens (IOL) implantation. The visual acuity, subjective glare and photophobia reduction, anatomic outcome, and complications were reviewed. Results Best corrected visual acuity was improved in 13 eyes (81.25%), remained stable in 2 eyes (12.25%) and decreased in 1 eye (6.25%). Photophobia and glare improved in every case except for one (93.75%). Notably, after surgery 12 patients (75.00%) reported no photophobia and 10 patients (62.50%) reported no glare. The median postoperative follow-up was 29.5 months, with a minimum of 5 months and a maximum of 189 months. All iris devices were in the correct position, and all eyes achieved the desired anatomic result. The IOL optic edges were covered in all areas by either residual iris or opaque portions of a prosthetic iris device. Conclusions In patients who have undergone previous iridocyclectomy for presumed iris melanoma, combined cataract surgery and iris prosthesis placement, with or without iris reconstruction, can lead to visual improvement as well as reduction of both glare and photophobia.