DECEMBER 2020 | EYEWORLD | 101
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said you may be able to notice the difference
once the artificial iris is in, but for the most part,
it's hard to tell at a conversational distance. If
there's residual iris tissue in the eye, that may
be darker than the implant as well.
Dr. Miller said centration is another factor
to be concerned about. When you're suturing,
especially with an open sky configuration, you
don't know for sure if it will be centered when
the cornea is back on. If it's not centered, it will
be too late at that point, Dr. Miller said. This
would be most noticeable in people with blue
irises.
This man suffered a hockey puck injury to his left eye in 2014 when he was 28 years old, resulting in globe rupture and orbital floor fracture. After
the globe repair and several surgeries to repair a retinal detachment, he was aphakic and had both a traumatic mydriasis and large inferior
iridectomy.
Source: Kevin M. Miller, MD
In terms of pearls for placing the device,
Dr. Miller said that every patient is unique, and
there's no cookie-cutter approach. "There's so
much pathology in these patients that surgeons
who do this have to have a lot of tricks in their
toolbox," he said.
Dr. Miller said that patients who receive
these devices are often very happy with the
outcome. "The vision is one thing, but there's a
huge psychological component when you lose a
part of your facial anatomy that's important for
self-esteem and cosmesis," he said.
