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Research Article: Combined scleral suture-fixated intraocular lens implantation and Iris cerclage pupilloplasty for aphakic eyes with traumatic mydriasis

Date Published: 2026-09-29

Abstract:
The aim of this study was to present the observational outcomes of scleral suture-fixated intraocular lens (IOL) implantation combined with iris cerclage pupilloplasty to treat aphakic eyes with traumatic mydriasis. A retrospective review was performed consisting of 9 aphakic eyes in 9 patients with traumatic mydriasis who underwent scleral suture-fixated IOL implantation combined with iris cerclage pupilloplasty. The mean age was 18.9?±?18.1 years and the mean follow-up time was 6.3?±?6.1 months. Best-corrected visual acuity improved from 0.94?±?0.75 logarithm of the minimum angle of resolution (logMAR) to 0.75?±?0.67 logMAR after the surgery ( p =?0.042). Intraocular pressure decreased from 17.81?±?6.37 mmHg to 13.70?±?3.64 mmHg ( p =?0.046). The pupil diameter reduced from 8.851?±?0.686?mm to 5.263?±?1.361?mm ( p =?0.0001). In addition, the symptom of photophobia had significantly alleviated. The difference of endothelial cell density was not statistically significant postoperatively ( p =?0.698). Scleral suture-fixated IOL implantation combined with iris cerclage is an effective method to achieve functional and cosmetic outcomes for aphakic eyes with traumatic mydriasis.

Introduction:
Iris-lens composite defect represents a common presentation of anterior segment disruption following ocular trauma ( 1 ). In the management of certain severe cases, primary lens extraction and vitrectomy without intraocular lens (IOL) implantation may serve as a safe therapeutic strategy. Among patients requiring secondary operation, aphakic eyes accompanied by traumatic mydriasis and inadequate capsular support pose substantial clinical challenges ( 2 ). Traumatic mydriasis constitutes a severe form of iris…

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