Implantation of a black diaphragm intraocular lens for traumatic aniridia

Purpose: To evaluate the suitability and safety of a black diaphragm posterior chamber intraocular lens (IOL). Setting: Department of Ophthalmology, Leeds General Infirmary, Leeds, United Kingdom. Methods: Seven patients who had secondary implantation of a Morcher 67G black diaphragm posterior chamber IOL were identified. All patients were men with a mean age of 42 years who had previous ocular trauma resulting in extensive loss of iris tissue (traumatic aniridia). Simultaneous penetrating keratoplasty was performed in 4 cases. Minimum follow-up was 10 months (mean 19 months). Results: Best corrected visual acuity improved in 5 cases and was unchanged In 1 case. The lens was well centered in 5 cases. Two cases developed secondary glaucoma. 1 requiring trabeculectomy. One case developed infective endophthalmitis but had a visual acuity of 6/18 at last follow-up, and 1 had a vitreous and anterior chamber hemorrhage, which resolved. Conclusions: The black diaphragm posterior chamber IOL overcame aphakia in eyes with considerable loss of iris tissue and may mitigate the visually disabling effects of traumatic aniridia. Although this lens appears safe, caution should be used in its implantation until more patients with longer follow-up are studied. J Cataract Refract Surg 1999; 25:808-813 (C) 1999 ASCRS and ESCRS.