Safety and efficacy of black iris diaphragm intraocular lens implantation in eyes with large iris defects: Report 4.

Purpose: To assess the safety and efficacy of Morcher 67B black iris diaphragm intraocular lens (IOL) implantation for managing large iris defects and aphakia.

Setting: Stein Eye Institute, UCLA, Los Angeles, California, USA.

Design: Prospective case series.

Methods: The demographic, preoperative, and postoperative data on patients implanted with a black iris diaphragm IOL and followed to 1 year were reviewed. Safety measures included loss of corrected distance visual acuity (CDVA), perioperative complications, adverse events, and secondary surgical interventions. Efficacy measures included CDVA with glare, daytime and nighttime glare symptom scores, and subjective cosmesis scores.

Results: Thirty-one eyes of 31 patients were implanted. There was a 7-line improvement in median Snellen CDVA (P < .001). Four eyes worsened more than 1 line. There was 1 minor intraoperative complication. Twenty-one eyes experienced postoperative complications, most of which were related to preexisting ocular comorbidities. Three adverse events included cystoid macular edema, corneal graft dehiscence, and uveitis with ocular hypertension. There were 12 secondary surgical interventions. The CDVA with glare improved 6 Snellen lines (P < .0001). The mean subjective glare symptoms improved 4.94 points on a 0 to 10 scale during the day (P < .0001) and 3.61 points at night (P < .0001). The mean cosmesis score improved 2.23 points (P < .0001) on the same scale.

Conclusion: Black iris diaphragm IOL implantation in aphakic eyes with large iris defects and significant ocular comorbidity was found to be relatively safe and very effective at improving CDVA and reducing light and glare sensitivity.