scleral fixation of an aniridic iol and penetrating keratoplasty: clinical outcomes in three cases

purpose: to report the outcomes of combined aniridic intraocular lens (iol) implantation via scleral fixation and penetrating keratoplasty (pkp) in three patients.  methods: this study included 3 patients who required pkp and had aniridia and/or aphakia requiring iol implantation. all subjects underwent aniridic iol scleral fixation after vitrectomy and removal of capsular remnants followed by pkp thereafter. we used a single-piece black-diaphragm aniridic iols (morcher, stuttgart, germany) in all cases.  results: mean postoperative follow-up was 24 (range 18-30) months. no complications occurred during surgery. visual acuity improved in all patients and all reported a subjective reduction in glare sensation. two cases developed elevated intraocular pressure (iop) after surgery. in one eye, iop was controlled with timolol but the other required ahmed glaucoma valve implantation. no patient developed chronic uveitis, cystoid macular edema or retinal detachment and all the patients were satisfied with the cosmetic results. conclusion: combined scleral fixation of an aniridic iol and penetrating keratoplasty improves visual disability and aesthetic appearance. it seems to be an acceptable procedure in patients suffering from corneal opacity and cataracts or aphakia but insufficient iris and zonulae.