title: Long-term efficacy and complications of black diaphragm intraocular lens implantation in patients with traumatic aniridia.
abstract: OBJECTIVE
  To determine the efficacy and complications of long-term black diaphragm intraocular (BDI) lens implantation in patients with traumatic aniridia.
  
  
  METHODS
  This study analysed the demographics, clinical evaluations and treatments of 95 patients with BDI lens implantation and 75 patients who wore rigid gas-permeable (RGP) contact lenses (CLs). The clinical examinations included evaluations of visual acuity (VA), best-corrected visual acuity (BCVA), intraocular pressure measurements (IOP), and corneal endothelial cell density (ECD). Ultrasound biomicroscopy (UBM) was used to observe the haptic lens positions.
  
  
  RESULTS
  In the BDI group, light sensitivity dramatically decreased postoperatively in all patients, and 78 patients (82.1%) had a BCVA score >20/200. A total of 36 eyes (37.89%) developed elevated IOP after the BDI lens implantation, and 12 eyes (12.63%) underwent glaucoma laser surgery. Corneal decompensation occurred in nine eyes (9.47%), three of which developed glaucoma. Twelve patients (12.63%) experienced limbal stem cell failure, and 16 patients (16.84%) had eccentric BDI lenses. All patients in the RGP group had a BCVA score ≥20/200. Only seven eyes (9.3%) had cornea complications. There were no statistically significant differences in either the IOP or ECD after wearing the RGP CLs.
  
  
  CONCLUSIONS
  Glaucoma, corneal decompensation, limbal stem cell failure, and eccentric BDI lenses appeared to be the major long-term complications in BDI lens implantation. BDI lens implantation could effectively improve postoperative outcomes by reducing glare disability, improving visual performance, and addressing cosmetic issues. Because the implantation of the BDI lens in traumatic aniridia had a high incidence of complications, this treatment should be used with caution, and the long-term complications should be seriously considered.
authors.affiliation: Department of Ophthalmology, Eye and ENT Hospital of Fudan University, Shanghai, People's Republic of China.
authors.forename: Xiaodi
authors.initials: X
authors.lastname: Qiu
authors.affiliation: Department of Ophthalmology, Eye and ENT Hospital of Fudan University, Shanghai, People's Republic of China.
authors.forename: Yinghong
authors.initials: Y
authors.lastname: Ji
authors.affiliation: Department of Ophthalmology, Eye and ENT Hospital of Fudan University, Shanghai, People's Republic of China.
authors.forename: Tianyu
authors.initials: T
authors.lastname: Zheng
authors.affiliation: Department of Ophthalmology, Eye and ENT Hospital of Fudan University, Shanghai, People's Republic of China.
authors.forename: Yi
authors.initials: Y
authors.lastname: Lu
mesh_terms: D000328:Adult; D002452:Cell Count; D003261:Contact Lenses; D065306:Corneal Injuries / Q000209:etiology; D004728:Endothelium, Corneal / Q000473:pathology; D015807:Eye Injuries, Penetrating / Q000601:surgery*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007429:Intraocular Pressure / Q000502:physiology; D007498:Iris / Q000293:injuries*; D019654:Lens Implantation, Intraocular / Q000009:adverse effects*; D007908:Lens, Crystalline / Q000293:injuries*; D007910:Lenses, Intraocular; D008297:Male; D033401:Microscopy, Acoustic; D008875:Middle Aged; D009798:Ocular Hypertension / Q000175:diagnosis / Q000209:etiology / Q000601:surgery; D011183:Postoperative Complications; D011474:Prosthesis Design; D016896:Treatment Outcome; D014792:Visual Acuity / Q000502:physiology
keywords: Contact lens; Cosmesis; Rehabilitation; Treatment Surgery