838 Review of the Literature on Iris Implantation in Aniridia Patients: Techniques and Clinical Outcomes

Aim This review aims to identify a variety of implantation techniques and their effect on clinical outcomes, and the surgical technique and prosthesis with the most favourable outcomes. Method Advanced searches were performed on PubMed, Scopus, Cochrane and Web of Science for studies up to and including 2021, using a set of pre-defined search terms. 17 studies were included in this review. Results The most common post-operative complications amongst the studies in this review were secondary glaucoma (47%), corneal endothelial decompensation (35%), retinal detachment (18%), prosthesis decentration (18%), limbal stem cell failure (12%) and vitreous haemorrhage (12%). 53% of studies included best-corrected visual acuity (BCVA) deterioration, of these; 67% used an iris-lens prosthesis, 33% used an artificial iris and none used an endocapsular capsular tension-like ring. 78% included the trans-scleral suture approach, 33% included sulcus implantation and 33% included in the bag implantation. 35% of studies showed all patients had experienced an increase in BCVA; 55% had used the ArtificialIris, 45% had used an iris-lens diaphragm. Conclusions There appears to be no definitive answer on which surgical technique and iris prosthesis has the most favourable outcomes. The ArtificalIris has slightly better outcomes throughout this review, however, longer follow-up times are needed. The trans-scleral suture technique is most commonly used, therefore, no real comparisons against other techniques could be made. Overall, iris implantation is beneficial as visual acuity is likely to be improved. Further research into mechanisms of complications, especially glaucomas, is recommended to prevent their formation in the future.