This video shows new surgical techniques, by a vitreoretinal approach, to place foldable artificial iris (AI) prostheses without fiber mesh, even in cases without capsular support. In a 60-year-old man with aniridia and a subluxation of the in-the-bag intraocular lens (IOL), the in-the-bag IOL dislocation was refixated by 2 cow hitches grasping the haptic of the IOL and a new haptic donor that was introduced in the capsular bag; a fiber-free AI was implanted over the repaired in-the-bag IOL. In a 39-year-old man, the surgical association of capsular bag transplant, capsular ring implant, IOL implant, and fiber-free AI implant (over the new in-the-bag IOL) was performed. A 39-year-old man with aphakia and aniridia was treated by an IOL transscleral fixation and a fiber-free AI, which was sutured to the sclera by 4 cow hitches. These techniques could be good alternatives, avoiding the use of iris prostheses with fiber mesh, even in aphakia cases.

Financial Disclosures: Drs. Antonio Arias-Palomero, Eva Avendano-Cantos, Javier Celis Sánchez, Laura Garcia-Filoso Moraleda, Fernando Gonzalez Del Valle, Augustin Núñez Sánchez, José Juan Valdés González, and Asensio Del Pozo Encarnacion disclose no financial relationships.