Management of aniridia and iris defects: an update on iris prosthesis options.

PURPOSE OF REVIEW: This review examines the advantages and limitations of the various iris prostheses as treatment for aniridia.

RECENT FINDINGS: Multiple prosthetic iris devices have been developed for implantation in eyes with aniridia. However, none is currently approved for use in the USA.

SUMMARY: Aniridia can be congenital or traumatic in etiology and can lead to glare and other visual disturbances. Treatment options include colored contact lenses, corneal tattooing, and corneal stromal implants, although these carry significant risks of infection and corneal scarring. Prosthetic iris devices can often simultaneously treat aphakia or cataract as well as aniridia, and various models are currently available around the world from Morcher GMBH (Kapuzinerweg 12, 70374 Stuttgart, Germany), Ophtec USA Inc. (6421 Congress Ave Suite 12, Boca Raton, FL 33487, USA) and HumanOptics (Erlangen, Germany). Surgical planning and technique are important in optimizing the safety of these devices. The CustomFlex iris prosthesis from HumanOptics can be implanted within the capsular bag or ciliary sulcus with scleral fixation and offers excellent cosmetic outcomes. At present, the HumanOptics prosthetic iris is being investigated in a multicenter clinical trial.