Anterior Iris Enclavation of a Black Intraocular Lens for Leukocoria

A 32-year-old black woman was evaluated due to the cosmetic appearance of her blind left eye, with exotropia and leukocoria, which were interfering with her professional, social and personal life. The eye showed a clear cornea, quiet anterior chamber, normal iris and a white pupillary reflex due to white cataract and fibrotic retinal detachment. The Artisan® pupil occluder was enclavated retropupillary, keeping the cataract intact. After incision suture, strabismus was corrected. Despite the uneventful immediate post-operative course, two weeks after surgery the patient presented with posterior dislocation of the pupil occluder by release of one of the haptics, which induced cataract subluxation. Intracapsular cataract extraction was performed and the pupil occluder was repositioned anterior to the iris. At one year follow-up the eye remains quiet. The exotropia was corrected and the pupil occluder is well centered with an excellent cosmetic appearance. The patient is extremely satisfied with the result.