title: Transscleral sulcus fixation of a small-diameter iris-diaphragm intraocular lens in combined penetrating keratoplasty and cataract extraction for correction of traumatic cataract, aniridia, and corneal scarring.
abstract: We present the case of a 36-year-old Hispanic man who presented with photophobia and hand motion acuity from a lacerated cornea. Primary repair had been performed 13 years earlier. In addition to a densely scarred cornea and a fibrotic, partially resorbed cataract, more than 300 degrees of iris loss was noted. The patient was treated with penetrating keratoplasty, cataract extraction, and implantation of a transsclerally fixated, small-diameter aniridic intraocular lens (IOL). Despite the significant iris loss, a small-diameter IOL was chosen over a standard larger aniridic IOL to allow safer, more controlled insertion through an 8.0 mm trephination. Following surgery, the visual acuity improved to 20/25 with no symptoms of glare or photophobia.
authors.affiliation: Devers Eye Institute, Portland, Oregon 97210, USA. paulphillipsmd@gmail.com
authors.forename: Paul M
authors.initials: PM
authors.lastname: Phillips
authors.forename: Neda
authors.initials: N
authors.lastname: Shamie
authors.forename: Edwin S
authors.initials: ES
authors.lastname: Chen
authors.forename: Mark A
authors.initials: MA
authors.lastname: Terry
mesh_terms: D000328:Adult; D015783:Aniridia / Q000601:surgery*; D002386:Cataract / Q000209:etiology; D002387:Cataract Extraction / Q000379:methods*; D003316:Corneal Diseases / Q000601:surgery*; D005131:Eye Injuries; D006801:Humans; D015948:Keratoplasty, Penetrating / Q000379:methods*; D019654:Lens Implantation, Intraocular / Q000379:methods*; D007908:Lens, Crystalline / Q000293:injuries*; D007910:Lenses, Intraocular; D008297:Male; D012590:Sclera / Q000601:surgery