What is artificial iris surgery?
The iris is the colour of the eyes while it is also a diaphragm that has an orifice in the centre, called the pupil.
We would consider implanting a iris prosthesis or artificial iris in cases where the iris tissue is completely or almost completely lost, because of trauma, multiple surgical procedures, multiple complications of the anterior segment, or congenital aniridia.
They are circular prostheses that can be made in a cosmetic way and can be obtained in the same colour as the other eye. They are implanted in the anterior chamber, in the part where the iris is usually found, and they are fitted onto the remains of the capsules or remains of an intraocular lens which is there after other surgical procedures, meaning that sometimes sutures are not required or that the sclera wall can be sutured with non-absorbable sutures.
When is this surgery indicated?
In general, artificial iris implants are normally used in cases of major disintegration of the anterior segment.
They are very often associated with cornea transplants, other times with alterations secondary to cataract surgery or trauma, anterior segment infections, etc.
How is it performed?
The procedure is performed under local or general anaesthesia, depending on the case. A small opening, around 3.5-4mm, is usually made, as these prostheses are usually foldable.
They are inserted into a cartridge, folded and inserted into the anterior chamber, fitted onto the sulcus, and then fixed in place using sutures.
Another way of inserting the implants is when a keratoplasy is performed. They are then inserted through the trepanation orifice, making it much easier to implant them in the anterior chamber.
The results are usually good and cosmetically excellent. We take photographs of the contralateral eye, the patient's other eye. We have a huge range of colours.
As it is an intraocular prosthesis, it has to be carefully fitted so that it does not irritate the delicate intraocular structures.
It must not rub against the ciliary body to prevent inflammation, as this may bring about occasionally postoperative inflammatory phenomena or increases in intraocular pressure with secondary glaucoma.
These are complex cases where the artificial iris is usually another step in an already complicated surgical procedure. As a consequence, its patients require strict monitoring. All the parameters and conditions of the anterior segment must be monitored in the postoperative period.