Black Diaphragm Intraocular Lens in Patients with Aniridia

We read with great interest the article by Al- Rashidi SH on black diaphragm intraocular lens (IOL) in patients with Aniridia.[1] We would like to congratulate the author for the interesting and well-written paper, but we have some concerns regarding the article. First, the author should have mentioned the site and size of the corneal incision made for the implantation of the IOL. As these IOLs are quite bulky, it would require at least a 9 mm incision to insert them into the anterior chamber. Such a large incision has the potential to damage the limbal stem cell population which may subsequently accelerate epithelial healing problems in patients with aniridia. Furthermore, these patients are prone to develop intraocular pressure elevation in the long term which may need a glaucoma filtering surgery, therefore it would be prudent to spare the superior limbus for possible future glaucoma procedures.