Eyeworld

149 EW INTERNATIONAL April 2016 Editors' note: Dr. Hashemi has no financial interest related to his comments. Contact information Hashemi: hhashemi@norc.ac.ir "Because in addition to vision problems, it affects patients' appear- ance by causing a head tilt, eye clo- sure, and blepharospasm in bright light, which can impair their social interactions," they explained. Photophobia increases as cata- ract develops because of the increase in glare. However, cataract surgery also increases photophobia and glare. Therefore, according to Dr. Farahi and colleagues, "to avoid worsening symptoms, cataract surgery must be combined with an approach to treat iris transillumina- tion by implantation of prosthetic iris devices." Like any other prosthetic devic- es, aniridia rings come with a down- side. "Disadvantages of aniridia rings include their fragility during surgery, potential complications such as raised IOP caused by crowding (2 rings and 1 IOL), and their postoper- ative rotation and misalignment of fins as a result of bag contracture," Dr. Farahi and colleagues said. However, they emphasized, none of the patients included in their study had any of these prob- lems. "Considering the acceptable results achieved with no significant complications, we recommend this approach for all OCA patients who have developed cataracts," they concluded. "Iris ring implantation during cataract surgery was an effective procedure for increasing vision and reducing glare disability in patients with OCA," Dr. Hashemi said. Despite that, there remains a need for further studies. "In light of the results and pa- tients' expressed satisfaction, a study should be performed to assess the outcomes of refractive lens exchange along with implantation of a PCIOL and prosthetic iris device in OCA pa- tients seeking refractive correction," Dr. Hashemi concluded. EW References 1. Burk SE, et al. Prosthetic iris implanta- tion for congenital, traumatic, or functional iris deficiencies. J Cataract Refract Surg. 2001;27:1732–1740. 2. Karatza EC, et al. Outcomes of prosthetic iris implantation in patients with albinism. J Cataract Refract Surg. 2007;33:1763–1769. 3. Wong VW, et al. Black diaphragm an- iridia intraocular lens for aniridia and albinism. Graefes Arch Clin Exp Ophthalmol. 2005;243:501–504. 4. Li JJ, et al. Aniridia rings implantation for treatment of congenital aniridia combined with cataract surgery: a case report. Int J Ophthalmol. 2010;3:368–369. 5. Farahi A, et al. Combined cataract surgery and aniridia ring implantation in oculocu- taneous albinism. J Cataract Refract Surg. 2015;41:2438–2443.

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