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Combined Aniridia Ring Implantation and Cataract Surgery in an AxenfeldRieger Syndrome: A UBM Report

Guerriero, Silvana M.D.; L'Abbate, Milena M.D.; La Tegola, Maria Gabriella M.D.; Alessio, Giovanni M.D.; Sborgia, Giancarlo M.D.

doi: 10.1097/ICL.0b013e3182050472
Case Report

Purpose: To describe ultrasound biomicroscopy (UBM) features in a patient with Axenfeld-Rieger syndrome (ARS) and cataract before and after anterior segment surgery using intraocular lens (IOL) and aniridic ring implantation (Morcher Aniridia rings 50 D).

Methods: Visual acuity, subjective glare disability, intraocular pressure, endothelial cell density, and UBM imaging were reviewed over a period of 1 year.

Results: One month after surgery, the operated eye showed improved visual acuity and visual comfort, and UBM examination showed a well-centered IOL and well-aligned aniridic ring fins. After 8 months, UBM examination showed contraction of the capsular bag, which appeared wrinkled, fibrous, and thickened. The capsular bag comprised the aniridic ring fins, causing misalignment. The glare disability had dropped from grade 0 to 3. The same outcome was present at 1 year.

Conclusion: Ultrasound biomicroscopy is a useful noninvasive diagnostic means to picture anatomic details before and after surgery; it suggested that capsular bag shrinking caused migration of the aniridic rings, 8 months after surgery.

From the Clinica Oculistica, Department of Ophthalmology and Otorhinolaryngology, University of Bari, Bari, Italy.

The authors have no proprietary interest in any of the materials used in this study, and they have not received funding for this work from any of the following organizations: National Institutes of Health (NIH); Wellcome Trust; Howard Hughes Medical Institute, and others.

Address correspondence and reprint requests to Dr. Silvana Guerriero, M.D., Department of Ophthalmology and Otorhinolaryngology, University of Bari, Piazza Giulio Cesare, 11 Bari, Italy; e-mail:

Accepted November 3, 2010.

© 2011 Lippincott Williams & Wilkins, Inc.