Clinical outcome of the artificial iris diaphragm in silicone oil surgery
- Department of Vitreo-Retinal Surgery, Center of Ophthalmology, University of Cologne, Cologne, Germany
- Correspondence to Dr Sascha Fauser, Department of Vitreo-Retinal Surgery, Center of Ophthalmology, University of Cologne, 50924 Cologne, Germany;
Contributors All authors contributed to the article: conception and design, or analysis and interpretation of data, drafting the article or revising it critically for important intellectual content and final approval of the version to be published.
- Accepted 21 February 2012
- Published Online First 9 March 2012
Background Some eyes require long-term silicone oil tamponade. Problems arise in aphakic eyes with iris defects or hypotony, because an inferior iridectomy can not prevent silicone oil from entering the anterior chamber causing keratopathy and glaucoma. The artificial iris diaphragm was developed to prevent these complications.
Methods In this retrospective case series, 94 consecutive aphakic eyes of 94 patients received an artificial iris diaphragm and a silicone oil tamponade. All eyes had hypotony or iris defects. The primary outcome measure was the retention of silicone oil behind the iris diaphragm. Secondary outcome measures included visual acuity, intraocular pressure and surgical revisions.
Results The mean follow-up time was 586 days. No silicone oil in the anterior chamber at the last follow-up visit was found in 58 cases (61.7%). The Kaplan–Meier survival analysis returned a mean survival time for a functional diaphragm of 1227 days. Keratopathy improved in 55.3% at least temporarily, and vision improved or remained stable in 38.2% until last follow-up. The diaphragm was more successful when the underlying disease was trauma or congenital malformation.
Conclusions The artificial iris diaphragm often retained silicone oil from the anterior chamber in severely damaged eyes. It can be useful to prevent phthisis and preserve vision.
- artificial iris diaphragm
- ciliary body
- silicone oil tamponade
- treatment surgery
- wound healing
Competing interests None.
Provenance and peer review Not commissioned; externally peer reviewed.