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    Il Gattopardo 3, or “The Leopard's Third Eye”

    AAO 2020 Video Program
    Retina/Vitreous, Vitreoretinal Surgery

    Post-traumatic cataract associated with sub-total aniridia requires complex reconstructive surgery. This video illustrates our approach to the surgical management of this condition by means of combined ArtificialIris and IOL implantation. The patient in this video suffered a severe penetrating ocular trauma, resulting in corneal wound, subtotal iridodialysis and total traumatic cataract, with preserved integrity of the capsular bag and zonule. Phacoemulsification with IOL implantation in the bag was performed (thanks to the integrity of the capsular bag and the intact zonule). An ArtificialIris prosthetic device was positioned in the sulcus without the need for suturing (sutureless implantation). Three weeks later, a 23-gauge pars plana vitrectomy was carried out to remove iris remnants dropped in the vitreous chamber (causing vitritis). Thanks to wide angle viewing systems, it was possible to obtain a perfect visualization of both the central and peripheral retina during the vitrectomy, despite the narrow artificial pupil. A year on, the patient presents an excellent anatomic reconstruction, with good functional recovery and optimal aesthetic results.