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EW INTERNATIONAL 148 April 2016 by Matt Young and Gloria Gamat EyeWorld Contributing Writers to customize pupil size, customize iris color, and improve flexibility of the material," they wrote in a case report published in the December 2010 issue of the International Journal of Ophthalmology. Outcomes of Iranian case series At the 2015 American Academy of Ophthalmology (AAO) annual meeting, a team of investigators from Iran presented the results of a combined cataract surgery/aniridia ring implantation in OCA patients. Results were assessed based on vision, refraction, eye movements, and subjective photophobia and glare. Patients included in the study underwent phacoemulsification and posterior chamber intraocular lens (PCIOL) implantation. The 2 anirid- ia rings (types 50 F or 50 E, Morcher, Stuttgart, Germany) were inserted intracapsularly. Visual acuity test, manifest refraction, measurement of ocular alignment, and electronystagmogra- phy (ENG) were conducted preop- eratively and postoperatively. After the surgery, patients completed a questionnaire to subjectively assess glare reduction. The data presented by Hassan Hashemi, MD, Tehran, Iran, at the 2015 AAO meeting was also pub- lished in the November 2015 issue of the Journal of Cataract and Refrac- tive Surgery. Azadeh Farahi, MD, and colleagues 5 reported the results of phacoemulsification and PCIOL implantation, as well as endocapsu- lar positioning of aniridia rings in a series of patients affected with OCA. "All patients reported marked reduction in glare disability and photophobia; ENG results indicat- ed considerable improvement in horizontal saccadic eye movements in each gaze; all surgeries were un- eventful, and there were no import- ant postoperative complications," they reported. Photophobia issue Among all ocular symptoms in OCA patients, Farahi and colleagues em- phasized, photophobia is one of the major issues. On the other hand, Victoria W.Y. Wong, MD, and colleagues 3 evaluated the safety and efficacy of primary and secondary implantation of a black diaphragm aniridia IOL in patients with iris deficiency, includ- ing OCA. "The black diaphragm aniridia IOL is useful in the management of the condition in patients with iris deficiency including oculocutane- ous albinism; intraoperative and postoperative complications are not uncommon and patients should be monitored carefully in the perioper- ative period," they reported in the May 2005 issue of Graefe's Archive for Clinical and Experimental Ophthal- mology. Juan-Juan Li, MD, and col- leagues 4 reported successful treat- ment of a patient suffering from a bilateral congenital aniridia and cataract with insertion of capsular tension rings and an IOL. "In patients with iris deficiency, implantation of aniridia rings and intraocular lens following cataract surgery appears to be safe and effec- tive in reducing glare and improving visual outcomes; however, addi- tional designs have to be achieved Benefits of artificial iris devices in OCA Scott Burk, MD, and colleagues 1 reported that implantation of pros- thetic iris devices reduced glare dis- ability and even corrected aphakia in selected cases. "Although operating on trau- matized, congenitally aniridic, or uveitic eyes presents special chal- lenges, implantation of prosthetic iris devices appears to be a safe and effective method for reducing the ubiquitous glare in patients with iris deficiency," they wrote in the November 2001 issue of the Journal of Cataract & Refractive Surgery. Similarly, in a retrospective non-comparative case series of patients with reduced iris pigmentation secondary to albinism, Ekaterini Karatza, MD, and colleagues 2 reported in the October 2007 issue of the Journal of Cataract & Refractive Surgery that prosthetic iris devices appear to be useful in the management of this patient population. "The procedure was safe and particularly effective in reducing glare and photophobia in most pa- tients," they concluded. New research from Iran buttresses aniridia ring evidence A lthough manifestations vary slightly, ocular characteristics found in all types of oculocutane- ous albinism (OCA) are distinctly similar. Light can scatter within the eye of OCA patients mainly because of hypopigmentation in the iris and choroid (iris translucency) and mac- ular hypoplasia. Furthermore, OCA patients suffering from cataracts end up with bigger problems. Cataract adds to OCA patients' already-existing visual conditions such as reduced acuity, nystagmus, photophobia, and glare. Indeed, symptoms such as pho- tophobia and glare are common in OCA patients, and can worsen after cataract surgery with IOL implanta- tion. To manage the condition, the use of artificial iris devices, accord- ing to a few studies, gives encourag- ing outcomes. Cataract surgery/aniridia ring combo shows potential against translucent irises International outlook

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