Sutureless Complex Anterior Segment Reconstruction

Traumatic aphakia and aniridia are some of the most complex anterior segment disorders that are challenging to manage for many ophthalmologists. Recent advances in surgical instruments and techniques, such as the introduction of artificial iris implants and sutureless intraocular lens fixation have shown promising results in addressing these issues albeit separately. We present a combinational technique that addresses both traumatic aphakia and aniridia using an Intra-Scleral Haptic Fixation (ISHF, aka Yamane) technique in one setting. Furthermore, we were able to replace the decompensated corneal endothelium with a DSAEK immediately after ISHF lens-artificial-iris insertion without complications. At the latest follow-up 2 months after the procedure, the cornea was completely clear of any edema and the visual acuity was improved dramatically.