Vitreoretinal surgery in posttraumatic aniridia

    Purpose. To determine tactics and strategy of treatment for combined vitreoretinal pathology and aniridia.
    Material and methods. There was performed a retrospective analysis of results in 141 implantations of artificial iris-lens diaphragm (ILD) in patients with posttraumatic partial or total aniridia for the period between 2002 and 2011. Endovitreal procedures for retinal detachment, crystalline lens subluxation or dislocation into the vitreous, significant vitreous opacities was required before and with ILD implantation in 101 eyes (of 101 patients). All patients were divided into three groups based on the severity of initial pathology that influenced on the choice of surgical method.
    Results. Surgical treatment achieved a complete retinal reattachment in all cases, except four patients, who underwent detachment surgery with silicone oil tamponade simultaneously with anterior chamber reconstruction and ILD implantation.
    Conclusion. The complete reattachment of the retina is an essential prerequisite for reconstructive surgery therefore in the majority of cases a two-stage approach is preferred. Vitreoretinal surgery with short-term (?3 months) tamponade with vitreous substitutes, including silicone oil is possible in proliferative vitroretinopathy of the B and C degrees with anterior or posterior contraction, large retinal tears and fibrosis. At the same time if peripheral retinal breaks or retinal dialysis are present, additional episcleral buckling is warranted. And ILD implantation should not be undertaken earlier than 12 months after silicone oil removal. After vitrectomy or episcleral buckle performed as a one-stage procedure, ILD implantation should be postponed for at least 6 months.
    Key words: posttraumatic aniridia, retinal detachment, artificial iris-lens diaphragm, vitreoretinal surgery.