UI Surgeon Performs High-Tech Iris Repair

After a sliver of steel went through Larry Molyneux’s right eye, the 68-year-old What Cheer, Iowa, man wasn’t sure he’d be able to keep the eye, let alone ever see again. But thanks to an artificial iris implant done by surgeons at University of Iowa Hospitals & Clinics using new technology—as well as a bit of fate that prevented the steel from damaging the optic nerve—Molyneux can not only see, but his injured eye looks like it was never injured at all.

Leading the way with advancements in eye care

Although artificial iris implants have been around for decades, until recently only a handful of places across the country were able to perform the procedure. It wasn’t until 2018 that the first iris prosthesis was approved for use in the United States.

Molyneux is the first patient in Iowa to receive this new, human-like silicone prosthetic iris.

“This is a significant advance in technology,” says Christopher Sales, MD, MPH, an ophthalmologist and surgeon at UI Hospitals & Clinics who performed Molyneux’s surgery. “Early implants didn’t look human— they helped with vision but significantly affected the appearance of the patient’s eye.”

The new human-like silicone implant is custom made using images of the patient’s healthy iris. Once manufactured it is a carbon copy of the healthy eye. Because of its silicone flexibility, surgeons are able to implant the iris through an incision roughly one-tenth of an inch long and with very little suturing.

“That’s not to say it’s an easy surgery; I’m folding an iris that is about the size of a cornea, which is about four times the size of the incision,” Sales says. “It’s tough to do, but it’s really beneficial for the patient. It’s a minimally invasive surgery with a faster recovery time.”

Seeing red: trauma to the eye

Molyneux was helping his nephews change tracks on a bulldozer in early February 2021 when he felt something hit his eye. He typically wears a pair of reading glasses when doing close work, but the inside of the machine shop was getting warm and his glasses kept slipping off his nose.

“I finally just took them off my nose and it wasn’t 10 seconds later a piece of steel came up and went right into my eye,” he says. He remembers the sting of pain but didn’t know yet that the steel was inside his eye.

His nephews loaded him into a truck and planned to take him to a local hospital, but when the truck hit a snowdrift Molyneux’s view of the world turned red.

“I turned to my nephew and told him I felt like I was looking through a window pane covered in blood,” Molyneux says.

“Iris Repair” continues on page 26