Change in refractive outcomes after custom, flexible iris prostheses placed secondarily within the capsular bag

Area of Science:

• Ophthalmology
• Biomedical Engineering

Background:

• Iris deficiencies affect cosmesis and visual function.
• Artificial iris prostheses improve outcomes but may interact with existing intraocular lenses (IOLs).
• Limited data exists on the refractive impact of in-the-bag iris prostheses on IOLs.

Purpose of the Study:

• To evaluate the refractive changes after surgical placement of a custom iris prosthesis in the capsular bag.
• To assess the impact of iris prostheses on intraocular lens (IOL) effectiveness.

Main Methods:

• Retrospective chart review of 13 eyes with custom, flexible iris prostheses.
• Data collected included biometry, IOL details, and pre- and post-operative refraction.
• Analysis of refractive shift in eyes with and without concomitant IOL procedures.

Main Results:

• Iris prosthesis placement alone resulted in an average +0.49D spherical equivalent shift.
• Aphakic eyes receiving secondary IOLs showed a +0.79D hyperopic shift.
• Eyes with concomitant IOL exchange experienced a 1.22D less myopic outcome than predicted.

Conclusions:

• Confirms a hyperopic refractive shift when both IOLs and iris prostheses are in the capsular bag.
• Highlights potential IOL undercorrection when combined with in-the-bag iris devices.
• Informs surgical planning for patients requiring both IOLs and iris prostheses.