A 43-year-old woman with post-traumatic aphakia, partial aniridia, and severe corneal scarring in the right eye underwent surgery 1 year after the trauma. An 8-mm partial-thickness trephination and manual full-thickness dissection was performed, and a temporary keratoprosthesis was fixated to perform posterior and anterior vitrectomy with removal of the vitreous and residual iris tissue remnants. The conjunctiva was marked at 2.5 mm from the limbus at 2, 6, and 10 clock hours. A 27-gauge needle with an unarmed 5.0 Prolene suture was inserted transconjunctivally in the eye through each mark, and the suture was grabbed and exposed on the opposite side using 27-gauge forceps. Each suture was then passed through the orifices of a flexible iris prosthesis with a built-in hydrophobic acrylic intraocular lens (IOL). The keratoprosthesis was removed, and the iris prosthesis was positioned in the sulcus. Finally, a donor cornea was sutured in place, and the IOL/iris complex was centered by adjusting the tension of the 5.0 Prolene sutures that were trimmed, flanged, and then buried under the conjunctiva.

Financial Disclosure: Drs. Luigi Fontana and Danilo Iannetta disclose no financial relationships.