Aniridie-IOL und künstlicher Irisersatz

 

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Zusammenfassung

Aniridie wird als Fehlen des Irisgewebes definiert, welches partiell, subtotal oder total auftreten kann. Zu den klinischen Symptomen gehören aufgrund des erhöhten Lichteinfalls häufig Photophobie und Einschränkungen des Sehvermögens. Des Weiteren stehen stark störende kosmetische Beeinträchtigungen im Vordergrund. Zur visuellen und kosmetischen Rehabilitation eignen sich moderne Irisimplantate. Zu ihnen zählen Aniridie-Intraokularlinsen (IOL), Iris-Segment-Implantate oder die „künstliche Iris“. Verschiedene Gesamt- und Pupillendurchmesser ermöglichen es, partielle und vollständige Irisrekonstruktionen durchzuführen. Mit Aniridie-IOLs kann gleichzeitig eine Aphakie oder Katarakt behandelt werden. Die Implantate können sowohl mittels intra- als auch extrakapsulärer Fixation eingesetzt werden. Die „künstliche Iris“ kann gefaltet und durch kleine Inzisionen implantiert werden. Die individuelle Farbauswahl steigert die Patientenzufriedenheit postoperativ.

Abstract

Aniridia is defined as missing iris tissue which can be partial, subtotal or total. Characteristic clinical symptoms include photophobia and decreased visual acuity due to an increased light perception. In addition, disturbing cosmetic problems are prevalent. Modern iris reconstruction implants offer visual and cosmetic rehabilitation. Amongst them are aniridia intraocular lenses (IOL), iris segment implants and the “artificial iris”. Different overall and pupil diameters are available for total or partial implants. At the same time aphakia or cataract can be treated when using aniridia IOLs. Intra- and extracapsular fixation is possible. The “artificial iris” can be folded and implanted through small incisions. The aesthetic results are improved significantly due to customised colour selection providing increased patient satisfaction postoperatively.

• Literatur

• 1 Hingorani M, Hanson I, van Heyningen V. Aniridia. Eur J Hum Genet 2012; 20: 1011-1017
  CrossrefPubMedGoogle Scholar
• 2 Oltra EZ, Chow CC, Lunde MW. Bilateral traumatic expulsive aniridia after phacoemulsification. Middle East Afr J Ophthalmol 2012; 19: 334-336
  CrossrefPubMedGoogle Scholar
• 3 Sheth HG, Laidlaw AH. Traumatic aniridia after small incision cataract extraction. Cont Lens Anterior Eye 2006; 29: 163-164
  CrossrefPubMedGoogle Scholar
• 4 Mikhail M, Koushan K, Sharda RK et al. Traumatic aniridia in a pseudophakic patient 6 years following surgery. Clin Ophthalmol 2012; 6: 237-241
  PubMedGoogle Scholar
• 5 Ninios K, Jonescu-Cuypers CP, Seitz B. [Glaucoma with primary iris malformations. Axenfeld-Rieger syndromes, ICE syndromes (essential iris atrophy, Chandlerʼs syndrome, Cogan-Reese syndrome), aniridia]. Ophthalmologe 2011; 108: 585-593 quiz 594
  CrossrefPubMedGoogle Scholar
• 6 Guerriero S, LʼAbbate M, La Tegola MG et al. Combined aniridia ring implantation and cataract surgery in an Axenfeld-Rieger syndrome: a UBM report. Eye Contact Lens 2011; 37: 45-47
  CrossrefPubMedGoogle Scholar
• 7 Khng C, Snyder ME. Iris reconstruction with a multipiece endocapsular prosthesis in iridocorneal endothelial syndrome. J Cataract Refract Surg 2005; 31: 2051-2054
  CrossrefPubMedGoogle Scholar
• 8 Neuhann IM, Neuhann TF. Cataract surgery and aniridia. Curr Opin Ophthalmol 2010; 21: 60-64
  CrossrefPubMedGoogle Scholar
• 9 Wolff J. [Prosthetic iris devices]. Ophthalmologe 2011; 108: 714-719
  CrossrefPubMedGoogle Scholar
• 10 Szurman P, Jaissle G. [Artificial iris]. Ophthalmologe 2011; 108: 720-727
  CrossrefPubMedGoogle Scholar
• 11 Alio JL, Rodriguez AE, Toffaha BT et al. Femtosecond-assisted keratopigmentation for functional and cosmetic restoration in essential iris atrophy. J Cataract Refract Surg 2011; 37: 1744-1747
  CrossrefPubMedGoogle Scholar
• 12 Alio JL, Rodriguez AE, Toffaha BT. Keratopigmentation (corneal tattooing) for the management of visual disabilities of the eye related to iris defects. Br J Ophthalmol 2011; 95: 1397-1401
  CrossrefPubMedGoogle Scholar
• 13 Kim JH, Lee D, Hahn TW et al. New surgical strategy for corneal tattooing using a femtosecond laser. Cornea 2009; 28: 80-84
  CrossrefPubMedGoogle Scholar
• 14 Grunauer-Kloevekorn C, Habermann A, Wilhelm F et al. [Contact lens fitting as a possibility for visual rehabilitation in patients after open globe injuries]. Klin Monatsbl Augenheilkd 2004; 221: 652-657
  Article in Thieme ConnectPubMedGoogle Scholar
• 15 Luo WL, Tong JP, Shen Y. Rigid gas-permeable contact lens for visual rehabilitation in aphakia following trauma. Clin Exp Optom 2012; 95: 499-505
  CrossrefPubMedGoogle Scholar
• 16 Sundmacher R, Reinhard T, Althaus C. Black-diaphragm intraocular lens for correction of aniridia. Ophthalmic Surg 1994; 25: 180-185
  PubMedGoogle Scholar
• 17 Reinhard T, Engelhardt S, Sundmacher R. Black diaphragm aniridia intraocular lens for congenital aniridia: long-term follow-up. J Cataract Refract Surg 2000; 26: 375-381
  CrossrefPubMedGoogle Scholar
• 18 Reinhard T, Sundmacher R, Althaus C. [Iris black diaphragm intraocular lenses in traumatic Aniridia]. Klin Monatsbl Augenheilkd 1994; 205: 196-200
  Article in Thieme ConnectPubMedGoogle Scholar
• 19 Petousis V, Krause L, Willerding G et al. Results and complications after implantation of a black iris-lens diaphragm in patients with traumatically induced aphakia and aniridia. Eur J Ophthalmol 2011; 21: 754-759
  CrossrefPubMedGoogle Scholar
• 20 Beltrame G, Salvetat ML, Chizzolini M et al. Implantation of a black diaphragm intraocular lens in ten cases of post-traumatic aniridia. Eur J Ophthalmol 2003; 13: 62-68
  CrossrefPubMedGoogle Scholar
• 21 Mavrikakis I, Mavrikakis E, Syam PP et al. Surgical management of iris defects with prosthetic iris devices. Eye (Lond) 2005; 19: 205-209
  CrossrefPubMedGoogle Scholar
• 22 Schmitz K, Viestenz A, Meller D et al. [Aniridia intraocular lenses in eyes with traumatic iris defects]. Ophthalmologe 2008; 105: 744-752
  CrossrefPubMedGoogle Scholar
• 23 Chung MY, Miller KM, Weissman BA. Morcher iris reconstruction lens and rigid contact lens for traumatic aniridia. Eye Contact Lens 2009; 35: 108-110
  CrossrefPubMedGoogle Scholar
• 24 Roman S, Cherrate H, Trouvet JP et al. [Artificial iris intraocular lenses in aniridia or iris deficiencies]. J Fr Ophtalmol 2009; 32: 320-325
  CrossrefPubMedGoogle Scholar
• 25 Aslam SA, Wong SC, Ficker LA et al. Implantation of the black diaphragm intraocular lens in congenital and traumatic aniridia. Ophthalmology 2008; 115: 1705-1712
  CrossrefPubMedGoogle Scholar
• 26 Menezo JL, Martinez-Costa R, Cisneros A et al. Implantation of iris devices in congenital and traumatic aniridias: surgery solutions and complications. Eur J Ophthalmol 2005; 15: 451-457
  PubMedGoogle Scholar
• 27 Wong VW, Lam PT, Lai TY et al. Black diaphragm aniridia intraocular lens for aniridia and albinism. Graefes Arch Clin Exp Ophthalmol 2005; 243: 501-504
  CrossrefPubMedGoogle Scholar
• 28 Mavrikakis I, Casey JM. Phacoemulsification and endocapsular implantation of an artificial iris intraocular lens in traumatic cataract and aniridia. J Cataract Refract Surg 2002; 28: 1088-1091
  PubMedGoogle Scholar
• 29 Burk SE, Da Mata AP, Snyder ME et al. Prosthetic iris implantation for congenital, traumatic, or functional iris deficiencies. J Cataract Refract Surg 2001; 27: 1732-1740
  CrossrefPubMedGoogle Scholar
• 30 Price MO, Price jr. FW, Chang DF et al. Ophtec iris reconstruction lens United States clinical trial phase I. Ophthalmology 2004; 111: 1847-1852
  CrossrefPubMedGoogle Scholar
• 31 Karatza EC, Burk SE, Snyder ME et al. Outcomes of prosthetic iris implantation in patients with albinism. J Cataract Refract Surg 2007; 33: 1763-1769
  CrossrefPubMedGoogle Scholar
• 32 Mashor RS, Bahar I, Kaiserman I et al. Combined penetrating keratoplasty and implantation of iris prosthesis intraocular lenses after ocular trauma. J Cataract Refract Surg 2011; 37: 582-587
  CrossrefPubMedGoogle Scholar
• 33 Sminia ML, Odenthal MT, Gortzak-Moorstein N et al. Implantation of the Artisan iris reconstruction intraocular lens in 5 children with aphakia and partial aniridia caused by perforating ocular trauma. J AAPOS 2008; 12: 268-272
  PubMedGoogle Scholar
• 34 Sakellaris D, Goossens C, Tassignon MJ. Customized iris clip anterior chamber intraocular lenses designed for iris reconstruction. Eur J Ophthalmol 2009; 19: 1084-1087
  PubMedGoogle Scholar
• 35 Olson MD, Masket S, Miller KM. Interim results of a compassionate-use clinical trial of Morcher iris diaphragm implantation: report 1. J Cataract Refract Surg 2008; 34: 1674-1680
  CrossrefPubMedGoogle Scholar
• 36 Li JJ, Li YP, Hu ZL. Aniridia rings implantation for treatment of congenital aniridia combined with cataract surgery: a case report. Int J Ophthalmol 2010; 3: 368-369
  PubMedGoogle Scholar
• 37 Srinivasan S, Yuen C, Watts M et al. Endocapsular iris reconstruction implants for acquired iris defects: a clinical study. Eye (Lond) 2007; 21: 1109-1113
  CrossrefPubMedGoogle Scholar
• 38 Ozturk F, Osher RH, Osher JM. Secondary prosthetic iris implantation following traumatic total aniridia and pseudophakia. J Cataract Refract Surg 2006; 32: 1968-1970
  CrossrefPubMedGoogle Scholar
• 39 Koch H-R, Linn L. A new foldable artificial iris. Indications, surgical techniques and first results. Clin Exp Ophthal 2008; 36: A1-A61
  CrossrefPubMedGoogle Scholar
• 40 Hermann MM, Muether PS, Kuhn L et al. Clinical outcome of the artificial iris diaphragm in silicone oil surgery. Br J Ophthalmol 2012; 96: 1008-1011
  CrossrefPubMedGoogle Scholar
• 41 Thumann G, Kirchhof B, Bartz-Schmidt KU et al. The artificial iris diaphragm for vitreoretinal silicone oil surgery. Retina 1997; 17: 330-337
  CrossrefPubMedGoogle Scholar
• 42 Heimann K, Konen W. [Artificial iris diaphragm in silicone oil surgery]. Fortschr Ophthalmol 1990; 87: 329-330
  PubMedGoogle Scholar
• 43 Heimann K, Konen W. Artificial iris diaphragm and silicone oil surgery. Retina 1992; 12: S90-S94
  CrossrefPubMedGoogle Scholar
• 44 Magnus J, Trau R, Mathysen DG et al. Safety of an artificial iris in a phakic eye. J Cataract Refract Surg 2012; 38: 1097-1100
  CrossrefPubMedGoogle Scholar
• 45 Ayliffe W, Groth SL, Sponsel WE. Small-incision insertion of artificial iris prostheses. J Cataract Refract Surg 2012; 38: 362-367
  CrossrefPubMedGoogle Scholar
• 46 Menapace RM, Snyder ME, Menezo JL et al. Cataract surgical problem. J Cataract Refract Surg 2008; 34: 1231-1235
  PubMedGoogle Scholar