Letter to parents
Dr .Vadim Bondar .GMS Clinic Moscow
In this letter I’m going to emphasize that we should not subject our children to artificial iris implantation. Congenital aniridia is a condition where the first obvious symptom is the absence of iris. The first but not the main one.
In case of congenital aniridia the most serious complications appear not due to the absence of iris but due to the side effects - such as glaucoma and corneal insufficiency .
Most parents ask me about possible surgical installation of an artificial iris. Mothers and fathers think that the absence of iris is the worst problem for their son or daughter. Frequently they don’t take into considiration that children don’t care about the absence of iris and most of adults with aniridia don’t care about it either. But parents know better and often they don’t listen. They start to seek and finally they find a surgeon who offers a surgery made to install an artificial iris. I want to ask these parents: "Please, think again" , maybe you want to hear a second opinion. If yes, why not listen to me?
I insist that nowadays implantation of an artificial iris is the worst choice which can be chosen. A surgical intervention of the kind may lead to serious complications and side effects.
I have seen patients after an artificial iris implantation, and I have never seen a happy outcome in case of congenital aniridia. I hear the same opinion from my colleagues. Tissues of an aniridia eye are not the same as in a normal healthy eye and a surgeon should have a very serious reason for any intervention. We know that any surgery may lead to aniridia fibrosis syndrome (AFS) with massive proliferation in anterior and posterior parts of eye. Continuing corneal insufficiency may lead to continuing pain. Increasing intraocular pressure leads to the optic nerve damage and total blindness.
Motivation. What for?
In most cases parents think that their child suffers because their eyes don’t look like other people’s do. But my experience shows that people with aniridia don’t care about it. They don’t care about the absence of iris.
There is no evidence that artificial lenses improve the visual function in case of aniridia. There is evidece that artifical iris increases the risk of glaucoma and corneal damage.
I strongly recommend to keep your children away from the this type of surgery and surgeons who suggest it.