CustomFlex® in Rhode Island

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About Artificial Irises

A natural iris, the colored, circular part of the eye, is responsible for much more than a person’s eye color. It also controls how much light enters the eye by widening or constricting the pupil. Patients who suffer from aniridia (the genetic absence of the iris) or other iris trauma can experience significant vision impairment, as well as extreme sensitivity to light. Beyond their visual symptoms, they can also suffer from emotional distress caused by the appearance of their eyes. However, these patients now have access to a procedure that can dramatically improve their condition.

CustomFlex artificial irises are the first FDA-approved iris prostheses in the U.S., though artificial irises have been in regular use in Europe for over 15 years. They are made with a medical-grade silicone and can be highly individualized in terms of patients’ eye color and iris size. While the “pupil” of the artificial iris does not open or close, it can be fixed at a much smaller diameter to work best with the functioning iris in the other eye.

At Koch Eye Associates, we always strive to provide our patients with the most innovative treatments and cutting-edge techniques to improve vision, eye health, and overall quality of life. We are very proud to have a skilled ophthalmology surgical team qualified to provide this service to our patients with these iris conditions. If you have aniridia or have experienced an iris injury, schedule a consultation at our Warwick, North Kingstown, Johnston, Woonsocket, or Wakefield, RI location to find out if you are a candidate for an artificial iris.

Best Candidates

The CustomFlex artificial iris is specially designed for individuals with aniridia (hereditary absence of the iris) or other iris trauma, such as partial or total removal due to melanoma. However, as with any surgical procedure, patients will need to have a comprehensive eye exam at Koch Eye Associates to determine if they are good candidates for the CustomFlex iris. It is important that patients considered for the procedure be in overall good health and not be pregnant. Other conditions that may restrict a patient’s candidacy include:

  • Active eye infection
  • Active intraocular infection
  • Uncontrolled, chronic, or severe inflammation of the eye
  • Abnormally small eye size
  • Untreated vision-threatening eye disorder (for example, retinal detachment or chronic glaucoma)
  • Diseases that cause abnormal blood vessels to grow on the iris
  • Proliferative diabetic retinopathy
  • Stargardt's retinopathy

Procedure Technique

Prior to the procedure, extremely detailed photographs will be taken of the patient’s unaffected iris. These photographs are used by the manufacturer of the CustomFlex iris to ensure they duplicate the iris’s appearance as closely as possible. If both of the patient's irises are affected, the patient can choose the appearance of his or her prostheses.

Surgery to place a CustomFlex iris is performed at the St. James Surgery Center in Warwick, RI. On the day of the procedure, the patient is given a local anesthetic to maximize comfort. A device is placed over the eye to keep the patient from blinking or moving, and a tiny incision is made. The artificial iris is very flexible and thin, and it can be rolled up to be inserted through the tiny incision. When it is in place, the surgeon will unroll it and smooth it out flat. Depending on the condition of the eye, the iris may be sutured into place or could be held in place by natural structures. The length of the surgery will depend on whether the patient is having one or both eyes treated or any other procedures done at the same time, such as a lens or cornea transplant.


It is very important that patients closely follow all of the aftercare instructions they are given after surgery. After an artificial iris insertion, these will most likely include sleeping in an upright position for a few nights and prescription antibiotic and anti-inflammatory eye drops. Following any eye surgery at Koch Eye Associates, we always schedule a follow-up appointment the next day and at least one more about a week after the surgery. Patients should be sure to attend the follow-up visits so we can monitor their healing and how the eye is adapting to the new iris. Most patients who undergo this procedure experience better vision and significant relief from light sensitivity and self-consciousness in the early weeks following the surgery.

relief from aniridia

Aniridia and other iris trauma can cause vision impairment and significant discomfort to patients, affecting daily functioning and quality of life. At Koch Eye Associates, we are proud to be able to provide these patients with relief from their symptoms and get them back to living their best lives. If you would like more information or think you might be a candidate for a CustomFlex artificial iris, contact us today. We will schedule a consultation with you at your nearest convenient Rhode Island facility.

*Individual results are not guaranteed and may vary from person to person. Images may contain models.