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Scleral sutured aniridia intraocular lens (Morcher®): indications and long-term outcomes

Eye (2024)Cite this article

Subjects

Abstract

Background/Objective

To evaluate the outcomes of trans-scleral sutured posterior chamber black diaphragm intraocular lens (BDIOL) (Morcher®) implantations over 11 years.

Subjects/Methods

Retrospective case-series of patients, who underwent BDIOL implantation, identified from electronic patient records system from 2006 to 2016, Moorfields Eye Hospital. Demographics, pre/post-operative, final best-corrected visual acuity (BCVA), diagnosis, symptomatic improvement, intraoperative and postoperative complications immediate or late were collected and analysed to relate outcomes to surgical indication.

Results

Forty eyes of 38 patients (F:M 1:2.8) underwent BDIOL implantation with a mean surgical age of 46.6 years and follow-up of 44.5 months (range of 8–132 months). Indications included 23(57%) ocular trauma, 7(17%) congenital aniridia, 7(17%) iatrogenic lens and/or iris loss, and 3(7%) infectious keratitis. Mean preoperative BCVA was 1.64 logMAR and mean final postoperative BCVA was 0.94 logMAR with an average improvement in BCVA of 0.23 logMAR, equivalent to 1.5 lines of Snellen visual acuity. Visual results varied according to indications. Infectious cause patients had the greatest vision improvement (−0.7 logMAR), followed by trauma (−0.3 logMAR), and 25% of these achieved vision of 0.3 logMAR (6/12 in Snellen acuity) or better. Conversely, the aniridia group had the least improvement (worsened vision of 0.01 logMAR), 17 patients (42%) reported subjective improvement.

Conclusion

BDIOLs achieve reasonably good visual outcomes in eyes with complex vision threatening pathology. No significant intra-operative complications are documented and most post-operative complications are related to the pre-existing pathology. Post – trauma and iatrogenic aniridia have better outcomes compared to congenital aniridia.

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Data availability

Data are available upon request to the corresponding author.

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Funding

Funding

No funding was received for the conduction of this study.

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Author notes

  1. These authors contributed equally: Rabia Bourkiza, Georgios Vakros.

Authors and Affiliations

  1. Department of Vitreoretinal Surgery, Moorfields Eye Hospital, 162 City Road, London, EC1V 2PD, UK

    Rabia Bourkiza, Georgios Vakros, Elizabeth Yang & David G. Charteris

  2. Department of Ophthalmology, Ninewells hospital, James Arrott drive, Dundee, DD2 1SG, UK

    Sonali Tarafdar

  3. NIHR Biomedical Research Centre at Moorfields Eye Hospital and University College London Institute of Ophthalmology, London, EC1V 2PD, UK

    David G. Charteris

Authors
  1. Rabia Bourkiza
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  4. Elizabeth Yang
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  5. David G. Charteris
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Contributions

RB. and G.V contributed equally in the following: Data acquisition and interpretation, drafting and revising the manuscript to its final version. GV is the corresponding author and responsible for the submission of the manuscript and agreed to be accountable for all aspects of the work in ensuring that questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved. DGC was responsible for conceptualisation and design of the study, critically revising and approved manuscript’s final version for submission. EY was responsible for data collection, statistical analysis and interpretation. ST was responsible for proposal submission to local ethics committee and data collection.

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Correspondence to Georgios Vakros.

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Bourkiza, R., Vakros, G., Tarafdar, S. et al. Scleral sutured aniridia intraocular lens (Morcher®): indications and long-term outcomes. Eye (2024). https://doi.org/10.1038/s41433-024-02982-w

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