Pars Planar Tube Surgery for Aniridia-Associated Keratopathy

Aniridia and its associated complications can pose significant challenges when performing glaucoma and vitreoretinal surgeries. In this surgical video, Dr. Lucy Shen and colleagues present a case of uncontrolled glaucoma in a 30-year-old African American female with a history of aniridia-associated keratopathy and nystagmus in both eyes. The left eye developed complications after combined keratoprosthesis and glaucoma surgeries. Hence, the surgeons decided not to perform keratoprosthesis surgery in the right eye. Although a glaucoma drainage tube was needed in the right eye, surgery would be challenging due to central corneal opacity, a shallow anterior chamber and visually significant cataract obscuring the view of the fundus. The patient underwent Ahmed valve surgery combined with pars plana lensectomy, pars plana vitrectomy and placement of the tube in the pars plana. Intraoperatively, endo-illumination was used to aid pars plana lensectomy. Visualization of the vitreous cavity through the opacified cornea was achieved using viscoelastic on the small clear portion of the cornea and a non-contact widefield viewing system. Postoperatively, the patient’s glaucoma remained controlled and IOP was maintained below 15 mm Hg in the right eye.

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