Abstract
Patients with large iris defects not only suffer from functional disadvantages but also from aesthetic limitations. The aim of this study was to evaluate the aesthetic outcome of iris reconstruction using an artificial iris (AI). In this study, 82 eyes of 79 consecutive patients with mostly traumatic partial or total aniridia that underwent iris reconstruction surgery using a custom-made silicone AI (HumanOptics, Erlangen, Germany). Pre- and postoperative photographs of 66 patients were analysed subjectively and objectively. Subjective evaluation was based questionnaires. Objective evaluation included measurement of pupil centration and iris colour analysis. Averaged hues from iris areas were transferred to numerical values using the LAB-colour-system. Single parameters and overall difference value (ΔE) were compared between AI and remaining iris (RI), as well as AI and fellow eye iris (FI). Patients, eye doctors and laymen rated the overall aesthetic outcome with 8.9 ±1.4, 7.7 ±1.1 and 7.3 ±1.1 out of 10 points, respectively. Mean AI decentration was 0.35 ±0.24 mm. Better pupil centration correlated with a higher overall score for aesthetic outcome (p<0.05). The AI was on average 4.65 ±10 points brighter than RI and FI. Aniridia treatment using a custom-made artificial iris prosthesis offers a good aesthetic outcome. Pupil centration was a key factor that correlated with the amount of aesthetic satisfaction. The AI was on average slightly brighter than the RI and FI.
Highlights
Eye contact plays an important role in successful social interaction. [1] In less than a second, often less than 120 ms, we unconsciously distinguish between sympathy and antipathy. [2,3,4] Minimal facial information is required as cues to judge credibility, competence and aggression in social interactions. [5] Altered eye appearance such as asymmetry or differences in colour, can be quickly noticed as annoying by an observer, and the patient may perceive his or her perceive own appearance as bothersome
Total absence of the iris is considered by the patient to be a severe aesthetic impairment, quite aside from visual symptoms it presents such as glare, reduced visual acuity and contrast sensitivity. [8]
There are only a few case reports and case series addressing the aesthetic outcome of this technique of iris reconstruction. [13,14,15,16,17] Our study aimed to systematically evaluate the aesthetic outcome of iris reconstruction using this custom-made silicone artificial iris prosthesis in a large group of patients with total and partial aniridia
Summary
Eye contact plays an important role in successful social interaction. [1] In less than a second, often less than 120 ms, we unconsciously distinguish between sympathy and antipathy. [2,3,4] Minimal facial information is required as cues to judge credibility, competence and aggression in social interactions. [5] Altered eye appearance such as asymmetry or differences in colour, can be quickly noticed as annoying by an observer, and the patient may perceive his or her perceive own appearance as bothersome (looking in a mirror or seeing self-photography). This does not alter our adherence to PLOS ONE policies on sharing data and materials. Treatment of partial and total aniridia includes tinted anti-glare spectacles, coloured irisprint contact lenses, lamellar intrastromal corneal tattoos and iris suturing techniques. These approaches can improve functionality and some enhance the aesthetic aspect, many patients find the treatment insufficient. There are only a few case reports and case series addressing the aesthetic outcome of this technique of iris reconstruction. [13,14,15,16,17] Our study aimed to systematically evaluate the aesthetic outcome of iris reconstruction using this custom-made silicone artificial iris prosthesis in a large group of patients with total and partial aniridia
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