Crystalline lens alterations in congenital aniridia | Archivos de la Sociedad Española de Oftalmología (English Edition)

 array:24 [
  "pii" => "S2173579421000773"
  "issn" => "21735794"
  "doi" => "10.1016/j.oftale.2020.12.008"
  "estado" => "S300"
  "fechaPublicacion" => "2021-11-01"
  "aid" => "1912"
  "copyright" => "Sociedad Espa&#241;ola de Oftalmolog&#237;a"
  "copyrightAnyo" => "2021"
  "documento" => "article"
  "crossmark" => 1
  "subdocumento" => "rev"
  "cita" => "Arch Soc Esp Oftalmol. 2021;96 Supl 1:38-51"
  "abierto" => array:3 [
    "ES" => false
    "ES2" => false
    "LATM" => false
  ]
  "gratuito" => false
  "lecturas" => array:1 [
    "total" => 0
  ]
  "Traduccion" => array:1 [
    "es" => array:19 [
      "pii" => "S0365669121000289"
      "issn" => "03656691"
      "doi" => "10.1016/j.oftal.2020.12.016"
      "estado" => "S300"
      "fechaPublicacion" => "2021-11-01"
      "aid" => "1912"
      "copyright" => "Sociedad Espa&#241;ola de Oftalmolog&#237;a"
      "documento" => "article"
      "crossmark" => 1
      "subdocumento" => "rev"
      "cita" => "Arch Soc Esp Oftalmol. 2021;96 Supl 1:38-51"
      "abierto" => array:3 [
        "ES" => false
        "ES2" => false
        "LATM" => false
      ]
      "gratuito" => false
      "lecturas" => array:1 [
        "total" => 0
      ]
      "es" => array:13 [
        "idiomaDefecto" => true
        "cabecera" => "<span class="elsevierStyleTextfn">Revisi&#243;n</span>"
        "titulo" => "Alteraciones del cristalino en la aniridia cong&#233;nita"
        "tienePdf" => "es"
        "tieneTextoCompleto" => "es"
        "tieneResumen" => array:2 [
          0 => "es"
          1 => "en"
        ]
        "paginas" => array:1 [
          0 => array:2 [
            "paginaInicial" => "38"
            "paginaFinal" => "51"
          ]
        ]
        "titulosAlternativos" => array:1 [
          "en" => array:1 [
            "titulo" => "Crystalline lens alterations in congenital aniridia"
          ]
        ]
        "contieneResumen" => array:2 [
          "es" => true
          "en" => true
        ]
        "contieneTextoCompleto" => array:1 [
          "es" => true
        ]
        "contienePdf" => array:1 [
          "es" => true
        ]
        "resumenGrafico" => array:2 [
          "original" => 0
          "multimedia" => array:7 [
            "identificador" => "fig0065"
            "etiqueta" => "Figura 13"
            "tipo" => "MULTIMEDIAFIGURA"
            "mostrarFloat" => true
            "mostrarDisplay" => false
            "figura" => array:1 [
              0 => array:4 [
                "imagen" => "gr13.jpeg"
                "Alto" => 1691
                "Ancho" => 2167
                "Tamanyo" => 264270
              ]
            ]
            "descripcion" => array:1 [
              "es" => "<p id="spar0075" class="elsevierStyleSimplePara elsevierViewall">Cuatro formas de evoluci&#243;n avanzada de la catarata en la aniridia&#46; Arriba izquierda&#58; mujer de 40<span class="elsevierStyleHsp" style=""></span>a&#241;os con opacidad cortical difusa y n&#250;cleo discretamente opalescente&#46; Arriba derecha&#58; mujer de 19<span class="elsevierStyleHsp" style=""></span>a&#241;os que experiment&#243; r&#225;pida p&#233;rdida de visi&#243;n y que presenta una catarata intumescente&#46; Su ojo adelfo&#44; que en ese momento ten&#237;a solo peque&#241;as opacidades subcorticales&#44; desarroll&#243; el mismo aspecto 6<span class="elsevierStyleHsp" style=""></span>meses despu&#233;s&#46; Abajo izquierda&#58; mujer de 45<span class="elsevierStyleHsp" style=""></span>a&#241;os con importante opacidad irregular y signos de reabsorci&#243;n parcial&#46; Abajo derecha&#58; hombre de 44<span class="elsevierStyleHsp" style=""></span>a&#241;os con catarata c&#243;rtico-nuclear madura&#44; n&#250;cleo muy brunescente y subluxaci&#243;n&#46;</p>"
            ]
          ]
        ]
        "autores" => array:1 [
          0 => array:2 [
            "autoresLista" => "F&#46; D&#8217;Oria, R&#46; Barraquer, J&#46;L&#46; Alio"
            "autores" => array:3 [
              0 => array:2 [
                "nombre" => "F&#46;"
                "apellidos" => "D&#8217;Oria"
              ]
              1 => array:2 [
                "nombre" => "R&#46;"
                "apellidos" => "Barraquer"
              ]
              2 => array:2 [
                "nombre" => "J&#46;L&#46;"
                "apellidos" => "Alio"
              ]
            ]
          ]
        ]
      ]
      "idiomaDefecto" => "es"
      "Traduccion" => array:1 [
        "en" => array:9 [
          "pii" => "S2173579421000773"
          "doi" => "10.1016/j.oftale.2020.12.008"
          "estado" => "S300"
          "subdocumento" => ""
          "abierto" => array:3 [
            "ES" => false
            "ES2" => false
            "LATM" => false
          ]
          "gratuito" => false
          "lecturas" => array:1 [
            "total" => 0
          ]
          "idiomaDefecto" => "en"
          "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S2173579421000773?idApp=UINPBA00004N"
        ]
      ]
      "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S0365669121000289?idApp=UINPBA00004N"
      "url" => "/03656691/00000096000000S1/v1_202111190822/S0365669121000289/v1_202111190822/es/main.assets"
    ]
  ]
  "itemSiguiente" => array:19 [
    "pii" => "S2173579421001377"
    "issn" => "21735794"
    "doi" => "10.1016/j.oftale.2020.11.011"
    "estado" => "S300"
    "fechaPublicacion" => "2021-11-01"
    "aid" => "1908"
    "copyright" => "Sociedad Espa&#241;ola de Oftalmolog&#237;a"
    "documento" => "article"
    "crossmark" => 1
    "subdocumento" => "rev"
    "cita" => "Arch Soc Esp Oftalmol. 2021;96 Supl 1:52-9"
    "abierto" => array:3 [
      "ES" => false
      "ES2" => false
      "LATM" => false
    ]
    "gratuito" => false
    "lecturas" => array:1 [
      "total" => 0
    ]
    "en" => array:13 [
      "idiomaDefecto" => true
      "cabecera" => "<span class="elsevierStyleTextfn">Review</span>"
      "titulo" => "Aniridic glaucoma&#58; An update"
      "tienePdf" => "en"
      "tieneTextoCompleto" => "en"
      "tieneResumen" => array:2 [
        0 => "en"
        1 => "es"
      ]
      "paginas" => array:1 [
        0 => array:2 [
          "paginaInicial" => "52"
          "paginaFinal" => "59"
        ]
      ]
      "titulosAlternativos" => array:1 [
        "es" => array:1 [
          "titulo" => "Actualizaci&#243;n en glaucoma anir&#237;dico"
        ]
      ]
      "contieneResumen" => array:2 [
        "en" => true
        "es" => true
      ]
      "contieneTextoCompleto" => array:1 [
        "en" => true
      ]
      "contienePdf" => array:1 [
        "en" => true
      ]
      "resumenGrafico" => array:2 [
        "original" => 0
        "multimedia" => array:8 [
          "identificador" => "fig0015"
          "etiqueta" => "Figure 3"
          "tipo" => "MULTIMEDIAFIGURA"
          "mostrarFloat" => true
          "mostrarDisplay" => false
          "figura" => array:1 [
            0 => array:4 [
              "imagen" => "gr3.jpeg"
              "Alto" => 808
              "Ancho" => 1207
              "Tamanyo" => 137632
            ]
          ]
          "detalles" => array:1 [
            0 => array:3 [
              "identificador" => "at0015"
              "detalle" => "Figure "
              "rol" => "short"
            ]
          ]
          "descripcion" => array:1 [
            "en" => "<p id="spar0015" class="elsevierStyleSimplePara elsevierViewall">Patient in <a class="elsevierStyleCrossRef" href="#fig0010">Fig&#46; 2</a> after penetrating keratoplasty and repositioning of the valve tube&#46;</p>"
          ]
        ]
      ]
      "autores" => array:1 [
        0 => array:2 [
          "autoresLista" => "F&#46;J&#46; Mu&#241;oz-Negrete, M&#46;A&#46; Teus, J&#46; Garc&#237;a-Feijo&#243;, M&#46;I&#46; Canut, G&#46; Rebolleda"
          "autores" => array:5 [
            0 => array:2 [
              "nombre" => "F&#46;J&#46;"
              "apellidos" => "Mu&#241;oz-Negrete"
            ]
            1 => array:2 [
              "nombre" => "M&#46;A&#46;"
              "apellidos" => "Teus"
            ]
            2 => array:2 [
              "nombre" => "J&#46;"
              "apellidos" => "Garc&#237;a-Feijo&#243;"
            ]
            3 => array:2 [
              "nombre" => "M&#46;I&#46;"
              "apellidos" => "Canut"
            ]
            4 => array:2 [
              "nombre" => "G&#46;"
              "apellidos" => "Rebolleda"
            ]
          ]
        ]
      ]
    ]
    "idiomaDefecto" => "en"
    "Traduccion" => array:1 [
      "es" => array:9 [
        "pii" => "S0365669120304287"
        "doi" => "10.1016/j.oftal.2020.11.005"
        "estado" => "S300"
        "subdocumento" => ""
        "abierto" => array:3 [
          "ES" => false
          "ES2" => false
          "LATM" => false
        ]
        "gratuito" => false
        "lecturas" => array:1 [
          "total" => 0
        ]
        "idiomaDefecto" => "es"
        "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S0365669120304287?idApp=UINPBA00004N"
      ]
    ]
    "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S2173579421001377?idApp=UINPBA00004N"
    "url" => "/21735794/00000096000000S1/v1_202111240624/S2173579421001377/v1_202111240624/en/main.assets"
  ]
  "itemAnterior" => array:19 [
    "pii" => "S2173579421001626"
    "issn" => "21735794"
    "doi" => "10.1016/j.oftale.2021.04.003"
    "estado" => "S300"
    "fechaPublicacion" => "2021-11-01"
    "aid" => "1936"
    "copyright" => "Sociedad Espa&#241;ola de Oftalmolog&#237;a"
    "documento" => "article"
    "crossmark" => 1
    "subdocumento" => "rev"
    "cita" => "Arch Soc Esp Oftalmol. 2021;96 Supl 1:15-37"
    "abierto" => array:3 [
      "ES" => false
      "ES2" => false
      "LATM" => false
    ]
    "gratuito" => false
    "lecturas" => array:1 [
      "total" => 0
    ]
    "en" => array:13 [
      "idiomaDefecto" => true
      "cabecera" => "<span class="elsevierStyleTextfn">Review</span>"
      "titulo" => "Aniridia and the ocular surface&#58; Medical and surgical problems and solutions"
      "tienePdf" => "en"
      "tieneTextoCompleto" => "en"
      "tieneResumen" => array:2 [
        0 => "en"
        1 => "es"
      ]
      "paginas" => array:1 [
        0 => array:2 [
          "paginaInicial" => "15"
          "paginaFinal" => "37"
        ]
      ]
      "titulosAlternativos" => array:1 [
        "es" => array:1 [
          "titulo" => "Aniridia y superficie ocular&#58; problemas y soluciones m&#233;dicas y quir&#250;rgicas"
        ]
      ]
      "contieneResumen" => array:2 [
        "en" => true
        "es" => true
      ]
      "contieneTextoCompleto" => array:1 [
        "en" => true
      ]
      "contienePdf" => array:1 [
        "en" => true
      ]
      "resumenGrafico" => array:2 [
        "original" => 0
        "multimedia" => array:8 [
          "identificador" => "fig0025"
          "etiqueta" => "Fig&#46; 5"
          "tipo" => "MULTIMEDIAFIGURA"
          "mostrarFloat" => true
          "mostrarDisplay" => false
          "figura" => array:1 [
            0 => array:4 [
              "imagen" => "gr5.jpeg"
              "Alto" => 598
              "Ancho" => 900
              "Tamanyo" => 77317
            ]
          ]
          "detalles" => array:1 [
            0 => array:3 [
              "identificador" => "at0025"
              "detalle" => "Fig&#46; "
              "rol" => "short"
            ]
          ]
          "descripcion" => array:1 [
            "en" => "<p id="spar0025" class="elsevierStyleSimplePara elsevierViewall">Patient with congenital aniridia and complete limbic insufficiency of long evolution&#46; Extensive conjunctivalization of the cornea is observed&#46;</p>"
          ]
        ]
      ]
      "autores" => array:1 [
        0 => array:2 [
          "autoresLista" => "J&#46; &#193;lvarez de Toledo Elizalde, S&#46; L&#243;pez Garc&#237;a, J&#46;M&#46; Ben&#237;tez del Castillo, J&#46; Dur&#225;n de la Colina, O&#46; Gris Castej&#243;n, J&#46; Celis S&#225;nchez, J&#46;M&#46; Herreras Cantalapiedra"
          "autores" => array:7 [
            0 => array:2 [
              "nombre" => "J&#46;"
              "apellidos" => "&#193;lvarez de Toledo Elizalde"
            ]
            1 => array:2 [
              "nombre" => "S&#46;"
              "apellidos" => "L&#243;pez Garc&#237;a"
            ]
            2 => array:2 [
              "nombre" => "J&#46;M&#46;"
              "apellidos" => "Ben&#237;tez del Castillo"
            ]
            3 => array:2 [
              "nombre" => "J&#46;"
              "apellidos" => "Dur&#225;n de la Colina"
            ]
            4 => array:2 [
              "nombre" => "O&#46;"
              "apellidos" => "Gris Castej&#243;n"
            ]
            5 => array:2 [
              "nombre" => "J&#46;"
              "apellidos" => "Celis S&#225;nchez"
            ]
            6 => array:2 [
              "nombre" => "J&#46;M&#46;"
              "apellidos" => "Herreras Cantalapiedra"
            ]
          ]
        ]
      ]
    ]
    "idiomaDefecto" => "en"
    "Traduccion" => array:1 [
      "es" => array:9 [
        "pii" => "S036566912100188X"
        "doi" => "10.1016/j.oftal.2021.04.003"
        "estado" => "S300"
        "subdocumento" => ""
        "abierto" => array:3 [
          "ES" => false
          "ES2" => false
          "LATM" => false
        ]
        "gratuito" => false
        "lecturas" => array:1 [
          "total" => 0
        ]
        "idiomaDefecto" => "es"
        "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S036566912100188X?idApp=UINPBA00004N"
      ]
    ]
    "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S2173579421001626?idApp=UINPBA00004N"
    "url" => "/21735794/00000096000000S1/v1_202111240624/S2173579421001626/v1_202111240624/en/main.assets"
  ]
  "en" => array:20 [
    "idiomaDefecto" => true
    "cabecera" => "<span class="elsevierStyleTextfn">Review</span>"
    "titulo" => "Crystalline lens alterations in congenital aniridia"
    "tieneTextoCompleto" => true
    "paginas" => array:1 [
      0 => array:2 [
        "paginaInicial" => "38"
        "paginaFinal" => "51"
      ]
    ]
    "autores" => array:1 [
      0 => array:4 [
        "autoresLista" => "F&#46; D&#8217;Oria, R&#46; Barraquer, J&#46;L&#46; Alio"
        "autores" => array:3 [
          0 => array:3 [
            "nombre" => "F&#46;"
            "apellidos" => "D&#8217;Oria"
            "referencia" => array:2 [
              0 => array:2 [
                "etiqueta" => "<span class="elsevierStyleSup">a</span>"
                "identificador" => "aff0005"
              ]
              1 => array:2 [
                "etiqueta" => "<span class="elsevierStyleSup">b</span>"
                "identificador" => "aff0010"
              ]
            ]
          ]
          1 => array:3 [
            "nombre" => "R&#46;"
            "apellidos" => "Barraquer"
            "referencia" => array:1 [
              0 => array:2 [
                "etiqueta" => "<span class="elsevierStyleSup">c</span>"
                "identificador" => "aff0015"
              ]
            ]
          ]
          2 => array:4 [
            "nombre" => "J&#46;L&#46;"
            "apellidos" => "Alio"
            "email" => array:1 [
              0 => "jlalio@vissum.com"
            ]
            "referencia" => array:3 [
              0 => array:2 [
                "etiqueta" => "<span class="elsevierStyleSup">a</span>"
                "identificador" => "aff0005"
              ]
              1 => array:2 [
                "etiqueta" => "<span class="elsevierStyleSup">d</span>"
                "identificador" => "aff0020"
              ]
              2 => array:2 [
                "etiqueta" => "&#42;"
                "identificador" => "cor0005"
              ]
            ]
          ]
        ]
        "afiliaciones" => array:4 [
          0 => array:3 [
            "entidad" => "Vissum Innovation&#44; Alicante&#44; Spain"
            "etiqueta" => "a"
            "identificador" => "aff0005"
          ]
          1 => array:3 [
            "entidad" => "Department of Basic Medical Science&#44; Neuroscience and Sense Organs&#44; University of Bari&#44; Bari&#44; Italy"
            "etiqueta" => "b"
            "identificador" => "aff0010"
          ]
          2 => array:3 [
            "entidad" => "Instituto Universitario Barraquer&#44; Universitat Aut&#242;noma de Barcelona&#44; Barcelona&#44; Spain"
            "etiqueta" => "c"
            "identificador" => "aff0015"
          ]
          3 => array:3 [
            "entidad" => "Divisi&#243;n de Oftalmolog&#237;a&#44; Universidad Miguel Hern&#225;ndez&#44; Alicante&#44; Spain"
            "etiqueta" => "d"
            "identificador" => "aff0020"
          ]
        ]
        "correspondencia" => array:1 [
          0 => array:3 [
            "identificador" => "cor0005"
            "etiqueta" => "&#8270;"
            "correspondencia" => "<span class="elsevierStyleItalic">Corresponding author</span>&#46;"
          ]
        ]
      ]
    ]
    "titulosAlternativos" => array:1 [
      "es" => array:1 [
        "titulo" => "Alteraciones del cristalino en la aniridia cong&#233;nita"
      ]
    ]
    "resumenGrafico" => array:2 [
      "original" => 0
      "multimedia" => array:8 [
        "identificador" => "fig0070"
        "etiqueta" => "Fig&#46; 14"
        "tipo" => "MULTIMEDIAFIGURA"
        "mostrarFloat" => true
        "mostrarDisplay" => false
        "figura" => array:1 [
          0 => array:4 [
            "imagen" => "gr14.jpeg"
            "Alto" => 2086
            "Ancho" => 3333
            "Tamanyo" => 524176
          ]
        ]
        "detalles" => array:1 [
          0 => array:3 [
            "identificador" => "at0070"
            "detalle" => "Fig&#46; 1"
            "rol" => "short"
          ]
        ]
        "descripcion" => array:1 [
          "en" => "<p id="spar0070" class="elsevierStyleSimplePara elsevierViewall">Evolution of the patient in <a class="elsevierStyleCrossRef" href="#fig0015">Fig&#46; 3</a> with development of opacities&#44; while the subluxation does not seem to increase significantly&#46; Top&#58; BE appearance at the age of 21 years&#59; cortical opacities have appeared in the inferior sectors&#46; Middle row&#58; the LE at age 27&#44; with progression of cortical opacities and development of opalescent nuclear cataract&#46; Bottom&#58; the RE at age 35&#44; with cortical cataract&#44; more diffuse but nucleus still transparent&#59; the densest opacity coincides with the area of greatest subluxation&#44; as revealed by retroillumination&#46; Bottom right&#58; the LE with diaphragm IOL implantation&#46;</p>"
        ]
      ]
    ]
    "textoCompleto" => "<span class="elsevierStyleSections"><span id="sec0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0025">Introduction</span><p id="par0005" class="elsevierStylePara elsevierViewall">Congenital aniridia is an ocular developmental anomaly associated with mutations in the PAX6 gene&#44; the <span class="elsevierStyleItalic">master gene</span> in ocular development&#46;<a class="elsevierStyleCrossRefs" href="#bib0005"><span class="elsevierStyleSup">1&#44;2</span></a> Said gene regulates other genes&#44; which explains the multiple ocular structures affected&#44; without respecting the classical embryonic layered division&#46; The classic ocular findings in aniridia are a combination of iris underdevelopment&#44; including the presence of only a rudimentary iris stump&#44; nystagmus&#44; foveal hypoplasia&#44; cataracts&#44; glaucoma and keratopathy with features of corneal limbus stem cell deficiency&#46;</p><p id="par0010" class="elsevierStylePara elsevierViewall">The impact of lens changes in aniridia on visual function is variable and often relatively minor among the multiple problems that these patients usually present with&#46; However&#44; they are the aspect of this disease that is most amenable to visual rehabilitation by surgical treatment&#46; This review will focus on the description of the clinically observed changes in the lens of aniridia patients&#44; as well as their etiopathogenesis and surgical treatment&#46;</p></span><span id="sec0010" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0030">Cataract phenotypes</span><p id="par0015" class="elsevierStylePara elsevierViewall">Lens alterations in aniridia can essentially fall into three clinical categories&#58; alterations related to transparency &#40;opacities or cataracts&#41;&#44; position &#40;subluxation&#41; which generally reveal zonular weakness&#44; and size and shape &#40;microspherophakia&#44; etc&#46;&#41;&#46;</p><span id="sec0015" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0035">Transparency alterations</span><p id="par0020" class="elsevierStylePara elsevierViewall">Lens opacities are very common in eyes with aniridia&#44; and in the literature their prevalence is estimated to be between 50&#8211;85&#37;<a class="elsevierStyleCrossRef" href="#bib0015"><span class="elsevierStyleSup">3</span></a>&#44; up to 88&#37; in a Korean cohort of 60 eyes<a class="elsevierStyleCrossRef" href="#bib0020"><span class="elsevierStyleSup">4</span></a> and above 90&#37; in a cohort of 26 Norwegian patients &#40;52 eyes&#41; with congenital aniridia&#46;<a class="elsevierStyleCrossRef" href="#bib0025"><span class="elsevierStyleSup">5</span></a></p><p id="par0025" class="elsevierStylePara elsevierViewall">Cataracts associated with aniridia vary in morphology and are described as polar&#44; cortical&#44; subcapsular&#44; lamellar and more rarely nuclear&#46; Small opacities&#44; either anterior polar&#44; posterior polar or both&#44; are typically present from birth and do not usually compromise vision&#46; This may explain the scant attention given to the presence of cataracts in some studies&#44; even recent ones&#46;<a class="elsevierStyleCrossRef" href="#bib0030"><span class="elsevierStyleSup">6</span></a> In our clinic experience we have found the following clinical types according to lens opacity degree&#58;<ul class="elsevierStyleList" id="lis0005"><li class="elsevierStyleListItem" id="lsti0005"><span class="elsevierStyleLabel">1</span><p id="par0030" class="elsevierStylePara elsevierViewall">Essentially clear lenses or only small anterior&#44; posterior or other off-axis polar opacities&#46; These are usually pediatric patients &#40;<a class="elsevierStyleCrossRef" href="#fig0005">Fig&#46; 1</a>&#41;&#46; A clear or nearly clear lens is most often associated with incomplete aniridia &#40;<a class="elsevierStyleCrossRef" href="#fig0010">Fig&#46; 2</a>&#41;&#44; but may coexist with glaucoma&#44; microspherophakia&#44; lens subluxation &#40;<a class="elsevierStyleCrossRef" href="#fig0015">Fig&#46; 3</a>&#41;&#44; or corneal opacities&#46;</p><elsevierMultimedia ident="fig0005"></elsevierMultimedia><elsevierMultimedia ident="fig0010"></elsevierMultimedia><elsevierMultimedia ident="fig0015"></elsevierMultimedia></li><li class="elsevierStyleListItem" id="lsti0010"><span class="elsevierStyleLabel">2</span><p id="par0035" class="elsevierStylePara elsevierViewall">Small to medium-sized anteriorly predominant opacities of polar&#44; subcapsular or cortical type&#46; There are multiple variants&#44; almost always with bilateral symmetry&#44; from the typical flat polar plaque of about 1&#160;mm&#44; either isolated &#40;<a class="elsevierStyleCrossRef" href="#fig0020">Fig&#46; 4</a>&#44; top left and centre&#41; or associated with peripheral coronary opacity &#40;<a class="elsevierStyleCrossRef" href="#fig0020">Fig&#46; 4</a>&#44; top right&#41;&#44; or with annular reinforcement at the edge &#40;<a class="elsevierStyleCrossRef" href="#fig0020">Fig&#46; 4</a>&#44; bottom&#41;&#46; Sometimes they are prominent&#44; pyramidal &#40;<a class="elsevierStyleCrossRef" href="#fig0025">Fig&#46; 5</a>&#41;&#44; or may have lamellar extensions towards the foveal nucleus or even multiple plaques &#40;<a class="elsevierStyleCrossRef" href="#fig0030">Fig&#46; 6</a>&#41;&#46;</p><elsevierMultimedia ident="fig0020"></elsevierMultimedia><elsevierMultimedia ident="fig0025"></elsevierMultimedia><elsevierMultimedia ident="fig0030"></elsevierMultimedia></li><li class="elsevierStyleListItem" id="lsti0015"><span class="elsevierStyleLabel">3</span><p id="par0040" class="elsevierStylePara elsevierViewall">A polar or axially predominant posterior subcapsular cataract&#44; sometimes associated with a polar or anterior subcapsular cataract&#44; which tends to progress peripherally&#44; either in the cortical plane &#40;<a class="elsevierStyleCrossRef" href="#fig0035">Fig&#46; 7</a>&#41; or in a somewhat deeper plane &#40;subcortical or lamellar&#41;&#46; It may also occur in cases of partial aniridia &#40;<a class="elsevierStyleCrossRef" href="#fig0040">Fig&#46; 8</a>&#41;&#46;</p><elsevierMultimedia ident="fig0035"></elsevierMultimedia><elsevierMultimedia ident="fig0040"></elsevierMultimedia></li><li class="elsevierStyleListItem" id="lsti0020"><span class="elsevierStyleLabel">4</span><p id="par0045" class="elsevierStylePara elsevierViewall">Posterior cataracts more extensive than the preceding group&#44; sometimes described as subcapsular but often concealing a subcortical plane&#46; Typically coralliform or petaloid in appearance&#44; with a series of radial opacities converging to a posterior axial nodule &#40;<a class="elsevierStyleCrossRef" href="#fig0045">Fig&#46; 9</a>&#41;&#46;</p><elsevierMultimedia ident="fig0045"></elsevierMultimedia></li><li class="elsevierStyleListItem" id="lsti0025"><span class="elsevierStyleLabel">5</span><p id="par0050" class="elsevierStylePara elsevierViewall">Lamellar &#40;zonular&#41; or cortical ring cataract&#46; Perhaps a variant of the previous one&#44; but predominantly peripheral and with some respect for the visual axis &#40;<a class="elsevierStyleCrossRef" href="#fig0050">Fig&#46; 10</a>&#41;&#44; at least until it progresses with age&#46;</p><elsevierMultimedia ident="fig0050"></elsevierMultimedia></li><li class="elsevierStyleListItem" id="lsti0030"><span class="elsevierStyleLabel">6</span><p id="par0055" class="elsevierStylePara elsevierViewall">Nuclear cataract&#46; It may rarely occur as an isolated congenital or infantile form &#40;<a class="elsevierStyleCrossRef" href="#fig0055">Fig&#46; 11</a>&#41;&#46; The nuclear component is seen as a developmental form associated with any of the preceding patterns in a somewhat older age group&#46; &#40;<a class="elsevierStyleCrossRef" href="#fig0060">Fig&#46; 12</a>&#41;&#46;</p><elsevierMultimedia ident="fig0055"></elsevierMultimedia><elsevierMultimedia ident="fig0060"></elsevierMultimedia></li><li class="elsevierStyleListItem" id="lsti0035"><span class="elsevierStyleLabel">7</span><p id="par0060" class="elsevierStylePara elsevierViewall">Very advanced or mature cataracts&#46; Progressive involvement of the cortex leads to diffuse opacity&#44; whether cortical&#44; cortico-nuclear or irregular&#46; In some cases there is a rapid progression with the formation of an intumescent cataract &#40;<a class="elsevierStyleCrossRef" href="#fig0065">Fig&#46; 13</a>&#41;&#46;</p><elsevierMultimedia ident="fig0065"></elsevierMultimedia></li></ul></p><p id="par0065" class="elsevierStylePara elsevierViewall">Finally&#44; there is a group of patients in whom the degree of cataract cannot be accurately established &#40;sometimes not at all&#41; due to the presence of corneal opacities or previous surgery&#46;</p></span><span id="sec0020" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0040">Position alterations</span><p id="par0070" class="elsevierStylePara elsevierViewall">The presence of lens subluxation <span class="elsevierStyleItalic">&#40;ectopia lentis&#41;</span> is also common in aniridia&#46; It has been estimated to occur in at least half of the eyes and almost always consists of an upward displacement&#46; As early as 1947 Beattie<a class="elsevierStyleCrossRef" href="#bib0035"><span class="elsevierStyleSup">7</span></a> described superior subluxation in 12 members of a family of 28 with aniridia&#44; as well as a much higher risk of glaucoma in cases with subluxation&#46; Since glaucoma in aniridia is associated&#44; at least in parts of the eyes&#44; with progressive angle closure by anterior synechiae&#44;<a class="elsevierStyleCrossRef" href="#bib0040"><span class="elsevierStyleSup">8</span></a> it is possible that the presence of subluxation facilitates the formation of such adhesions by lens movements&#46; Zonule degeneration in aniridia is possibly due to alteration &#40;hypoplasia&#41; of the ciliary body&#44; an aspect that has been clinically assessed by ultrasound biomicroscopy&#46;<a class="elsevierStyleCrossRef" href="#bib0045"><span class="elsevierStyleSup">9</span></a> We have found that cortical opacities in subluxated crystalline lenses tend to develop more in the area with increased zonular defect &#40;<a class="elsevierStyleCrossRef" href="#fig0070">Fig&#46; 14</a>&#41;&#46;</p><elsevierMultimedia ident="fig0070"></elsevierMultimedia><p id="par0075" class="elsevierStylePara elsevierViewall">Another possible alteration in the position of the lens would be the presence of kerato-lenticular adhesion&#46; This has been described in association with aniridia and causing cataract&#46;<a class="elsevierStyleCrossRef" href="#bib0050"><span class="elsevierStyleSup">10</span></a> We have observed this configuration in an infant with incomplete aniridia&#44; opacity of an entire corneal quadrant and kerato-lenticular adhesion&#44; but still with little lens opacity&#44; all bilateral and symmetrical &#40;<a class="elsevierStyleCrossRef" href="#fig0075">Fig&#46; 15</a>&#41;&#46; This is probably a picture of anterior segment dysgenesis analogous to Peters anomaly&#44; which in some cases has also been related to the PAX6 gene&#46;<a class="elsevierStyleCrossRef" href="#bib0055"><span class="elsevierStyleSup">11</span></a></p><elsevierMultimedia ident="fig0075"></elsevierMultimedia><p id="par0080" class="elsevierStylePara elsevierViewall">Even in cases without obvious subluxation&#44; biomicroscopic examination of the zonular region allowing for the absence of the iris often reveals an increased width of the space outside the crystalline equator&#44; typically in the inferior sector &#40;see <a class="elsevierStyleCrossRefs" href="#fig0005">Figs&#46; 1&#44; 3&#44; 9&#44; 12</a>&#8230;&#41;&#46; This is a sign of incipient zonular distension due to weakness or loss of fibres&#46;</p></span><span id="sec0025" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0045">Size and shape alterations</span><p id="par0085" class="elsevierStylePara elsevierViewall">Changes in the shape of the lens have been described&#44; which could be a consequence of zonular weakness or the manifestation of a malformation of the lens itself&#46; On computed tomography Mehta et al&#46;<a class="elsevierStyleCrossRef" href="#bib0060"><span class="elsevierStyleSup">12</span></a> observed an apparent inversion of the lens curvatures in a case of aniridia&#44; with greater convexity in the anterior than in the posterior&#44; which does not occur in traumatic subluxations&#46; However&#44; B-echography revealed that this change in shape occurred &#8220;in the cataract and not in the capsule&#8221;&#46; On the other hand&#44; the maintenance of the shape of a membranous cataract after dislocation to the vitreous has been reported in a patient with aniridia who had undergone valve implantation for glaucoma&#46;<a class="elsevierStyleCrossRef" href="#bib0065"><span class="elsevierStyleSup">13</span></a> We have observed in several cases of aniridia an increase in the anterior curvature of the lens&#44; sometimes described as &#8220;anterior lenticonus&#8221;&#44; which appears more convex than the posterior one in the absence of cataracts &#40;<a class="elsevierStyleCrossRef" href="#fig0080">Fig&#46; 16</a>&#41;&#46;</p><elsevierMultimedia ident="fig0080"></elsevierMultimedia><p id="par0090" class="elsevierStylePara elsevierViewall">In cases with microphakia or microspherophakia &#40;<a class="elsevierStyleCrossRef" href="#fig0015">Fig&#46; 3</a>&#41;&#44; the small size of the lens may be due to lens hypoplasia&#44; secondary to zonule weakness or even to a process of resorption&#46; When subluxation occurs in infancy&#44; the area with the largest zonular defect is seen to be reduced as well as rounded&#46; This is also seen in other forms of <span class="elsevierStyleItalic">ectopia lentis</span> and seems to be a consequence of the high elasticity of the lens in children&#46; If the zonular weakness is widespread&#44; a soft lens will tend to be spherical in shape and smaller in diameter&#46;</p><p id="par0095" class="elsevierStylePara elsevierViewall">Spontaneous lens resorption has been reported in a Japanese family with aniridia and microcornea&#44; over three generations and perhaps a fourth&#46;<a class="elsevierStyleCrossRef" href="#bib0070"><span class="elsevierStyleSup">14</span></a> We have occasionally observed partial resorption with formation of a membranous cataract&#44; almost always associated with significant subluxation&#46; In at least one case we found &#8211; during keratoplasty &#8211; the total absence of the lens with no history of surgery or trauma&#44; and no ultrasound evidence of subsequent dislocation&#44; while the fellow eye did have a cataract&#46; This could be spontaneous reabsorption&#44; with or without previous dislocation&#44; or else agenesis of the lens&#44; which we have also observed in eyes with Peters anomaly&#46;</p></span></span><span id="sec0030" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0050">Cataract genomics in aniridia</span><p id="par0100" class="elsevierStylePara elsevierViewall">Aniridia is due to point mutations or chromosomal deletions affecting the activity of the PAX6 gene&#44; located in humans on chromosome 11p13&#46; The previous association with markers on chromosome 2p<a class="elsevierStyleCrossRef" href="#bib0075"><span class="elsevierStyleSup">15</span></a> &#8211; also called type I aniridia&#44; while type II was associated with PAX6 &#8211; has been disproved by further genetic studies of the same families&#46;<a class="elsevierStyleCrossRef" href="#bib0080"><span class="elsevierStyleSup">16</span></a> Deletions on 11p13 that result in deletion of the PAX6 gene and its neighbouring genes can lead to systemic abnormalities&#46; The classic syndrome occurring in 11p13 deletions is the so-called WAGR syndrome &#40;Wilms&#8217; tumour&#44; aniridia&#44; genitourinary anomalies and mental retardation&#41;&#46; Wilms&#8217; tumour and genitourinary anomalies result from disruption of the WT1 gene&#44; a transcription factor gene located in the vicinity of PAX6&#46; Aniridia has also been described in association with systemic findings other than those found in WAGR syndrome&#58; the Gillespie syndrome is a very rare condition presenting with aniridia&#44; cerebellar ataxia and mental retardation&#46;<a class="elsevierStyleCrossRef" href="#bib0085"><span class="elsevierStyleSup">17</span></a> Other mutations in the PAX6 gene have been associated with some cases of Peters anomaly<a class="elsevierStyleCrossRef" href="#bib0055"><span class="elsevierStyleSup">11</span></a> and more recently with bilateral microphthalmia&#44; cataracts&#44; glaucoma and nystagmus in one family&#44; and in another with various ocular &#40;nystagmus&#44; cataracts&#44; foveal hypoplasia&#44; colobomas&#8230;&#41; and neurological malformations&#44; but without iridian defect&#46;<a class="elsevierStyleCrossRef" href="#bib0090"><span class="elsevierStyleSup">18</span></a></p><p id="par0105" class="elsevierStylePara elsevierViewall">The mechanisms by which genetic defects cause ocular alterations in aniridia are not precisely understood&#46; Although the cells of the optic vesicle and lens originate from different embryonic layers &#8211; respectively the neuroectoderm and the superficial ectoderm &#8211; their development involves a series of mutual induction relationships&#46; This leads to the question of whether the alterations in aniridia are due to primary dysfunction of PAX6 activity in one&#44; the other or both cell types&#46; Until recently there was some consensus on some aspects pointing to a predominant role of the lens<a class="elsevierStyleCrossRefs" href="#bib0095"><span class="elsevierStyleSup">19&#44;20</span></a>&#58;<ul class="elsevierStyleList" id="lis0010"><li class="elsevierStyleListItem" id="lsti0040"><span class="elsevierStyleLabel">&#8226;</span><p id="par0110" class="elsevierStylePara elsevierViewall">The primary defect that gives rise to the <span class="elsevierStyleItalic">small eye</span> phenotype &#8211; due to mutation of PAX6 in the mouse and used as an animal model of aniridia &#8211; is the failure of the surface ectoderm to form the crystalline placode&#46;</p></li><li class="elsevierStyleListItem" id="lsti0045"><span class="elsevierStyleLabel">&#8226;</span><p id="par0115" class="elsevierStylePara elsevierViewall">The development of the lens vesicle requires PAX6 activity in the prospective lens ectoderm but not in the optic vesicle&#46;</p></li><li class="elsevierStyleListItem" id="lsti0050"><span class="elsevierStyleLabel">&#8226;</span><p id="par0120" class="elsevierStylePara elsevierViewall">PAX6 is not essential for the formation of the optic vesicle&#44; although it is involved in later stages of retinogenesis&#46;</p></li></ul></p><p id="par0125" class="elsevierStylePara elsevierViewall">However&#44; it has been shown that PAX6 expression in the mouse optic vesicle is necessary to maintain the contact of the mouse optic vesicle with the lens epithelium&#44; which in turn is necessary for subsequent inductive interactions to take place&#46;<a class="elsevierStyleCrossRef" href="#bib0105"><span class="elsevierStyleSup">21</span></a> More recent studies in chick embryos indicate that PAX6 expression in the optic vesicle does play a role in the regulation of cell survival in the optic vesicle&#44; as well as in lens development &#40;beyond the lens vesicle stage&#41;&#44; at least during a narrow time window&#46;<a class="elsevierStyleCrossRefs" href="#bib0110"><span class="elsevierStyleSup">22&#44;23</span></a> Normal ocular development would therefore require the correct expression of PAX6 in <span class="elsevierStyleItalic">both</span> structures&#46;</p><p id="par0130" class="elsevierStylePara elsevierViewall">On the other hand&#44; Collinson et al&#46;<a class="elsevierStyleCrossRef" href="#bib0120"><span class="elsevierStyleSup">24</span></a> observed that&#44; in <span class="elsevierStyleItalic">small eye</span> mouse chimeras with up to 80&#37; PAX6 mutant cells&#44; these were replaced in the lens vesicle by normal cells &#40;which reproduce more actively&#41; from day 16 of development&#44; but not in other ocular tissues&#46; Despite this&#44; ocular size&#44; iris and corneal defects normalised in the fetal and adult periods&#46; Therefore&#44; these aspects of the phenotype could be <span class="elsevierStyleItalic">secondary</span> to the primary alterations of the lens and not to an effect of the PAX6 mutation on these structures&#46; Extrapolating to humans&#44; these authors suggest that partial therapeutic correction of the lens by gene therapy &#40;even if only effective in a percentage of the cells&#41;&#44; in embryos with aniridia genotype and identified by prenatal diagnosis<a class="elsevierStyleCrossRef" href="#bib0125"><span class="elsevierStyleSup">25</span></a> could significantly improve several of the clinical defects responsible for subsequent poor vision&#44; ocular degeneration and blindness&#46;<a class="elsevierStyleCrossRef" href="#bib0130"><span class="elsevierStyleSup">26</span></a></p></span><span id="sec0035" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0055">Indications and surgical management</span><p id="par0135" class="elsevierStylePara elsevierViewall">Congenital aniridia complicated by cataract does not require treatment when lens opacity and its effects on visual acuity are mild&#46; In addition&#44; patients with aniridia often have limited visual acuity from birth due to foveal hypoplasia or possible optic nerve hypoplasia&#46; It is important to determine when the decrease in visual acuity is caused by cataract alone or by other ocular pathologies that may decrease vision&#44; especially in patients with foveal hypoplasia&#46; Several methods have been developed to predict retinal visual acuity and how much vision may improve after surgery&#44; from electroretinography or visual evoked potentials to simpler and equally effective methods such as the <span class="elsevierStyleItalic">Vryghem Macular Function Test</span> &#40;MFT&#41;&#44; which uses a Parinaud near reading chart with a &#43;8 dioptre addition lens and a Heine ophthalmoscope&#46;<a class="elsevierStyleCrossRef" href="#bib0135"><span class="elsevierStyleSup">27</span></a></p><p id="par0140" class="elsevierStylePara elsevierViewall">However&#44; progressive decline in visual acuity usually occurs in adulthood due to the development of presenile cataracts&#44; which requires surgery with careful preoperative planning&#46; First of all&#44; continuous circular capsulorhexis &#40;CCC&#41; must be treated with great care&#46; The anterior capsules of patients with congenital aniridia are thin and fragile with degenerative changes in the epithelial cells&#44; as has been demonstrated in histological studies&#44;<a class="elsevierStyleCrossRef" href="#bib0140"><span class="elsevierStyleSup">28</span></a> which may predispose to the development of capsular tears&#46;</p><p id="par0145" class="elsevierStylePara elsevierViewall">Secondly&#44; the use of a capsular tension ring &#40;CTR&#41; can significantly reduce the likelihood of postoperative intraocular lens dislocation&#44; postoperative posterior capsule fibrosis &#40;PCO&#41; &#8211; patients with congenital aniridia are usually young&#44; so the incidence of PCO is very high &#8211; and anterior capsule fibrosis&#46;<a class="elsevierStyleCrossRef" href="#bib0145"><span class="elsevierStyleSup">29</span></a> In addition&#44; many of these patients may have nystagmus&#44; which poses difficulties during Nd&#58;YAG laser treatment&#46; One possible option is to perform posterior CCC with anterior vitrectomy at the time of cataract surgery in these eyes&#46; Wang et al&#46;<a class="elsevierStyleCrossRef" href="#bib0150"><span class="elsevierStyleSup">30</span></a> operated on 10 patients &#40;17 eyes&#41; with cataract and congenital aniridia&#44; with posterior chamber yellow IOL implantation and CTR to stabilise the zonules and prevent future intraocular lens dislocation&#46; In that study&#44; no intraocular lens dislocation occurred and there were no cases of secondary glaucoma or corneal endothelial decompensation&#46; Li et al&#46;<a class="elsevierStyleCrossRef" href="#bib0155"><span class="elsevierStyleSup">31</span></a> performed cataract surgery on 24 eyes &#40;12 patients&#41; with congenital aniridia&#58; most patients had some improvement in visual acuity and quality of vision&#46; <a class="elsevierStyleCrossRef" href="#tbl0005">Table 1</a> summarises the demographic characteristics&#44; visual outcomes and complications of the main studies on patients with cataract and congenital aniridia&#46;</p><elsevierMultimedia ident="tbl0005"></elsevierMultimedia><p id="par0150" class="elsevierStylePara elsevierViewall">The possibility of spontaneous evolution towards subluxation or complete dislocation must be considered in the surgical approach to any case of aniridia with cataract&#44; as these are often young patients with a long life expectancy&#46; For this reason&#44; some authors advise against the use of in-sac fixation for implants<a class="elsevierStyleCrossRef" href="#bib0160"><span class="elsevierStyleSup">32</span></a> or even advocate simple lensectomy without implant when there is clear subluxation&#46;<a class="elsevierStyleCrossRef" href="#bib0165"><span class="elsevierStyleSup">33</span></a> The various techniques of fixation in the absence of capsular support nevertheless allow a lens to be implanted in any case in which it is deemed useful&#46; A study of diaphragm lenses implanted in front of the capsular sac&#44; supported by the ciliary sulcus&#44; indicates good stability after 46 months of mean follow-up&#44; although complications are not avoided in some cases&#44; such as glaucoma deterioration &#40;4 of 19 eyes&#41; or chronic endothelial loss &#40;3 of 11 eyes&#41;&#46;<a class="elsevierStyleCrossRef" href="#bib0170"><span class="elsevierStyleSup">34</span></a> Reinhard et al&#46;<a class="elsevierStyleCrossRef" href="#bib0170"><span class="elsevierStyleSup">34</span></a> reported the results of black diaphragm IOL implantation in 19 eyes with congenital aniridia&#46; Glaucoma deterioration occurred postoperatively in 4 of 5 eyes with preoperative glaucoma&#44; while 4 of 14 eyes without preoperative glaucoma developed chronic glaucoma postoperatively&#46; Other authors have also found that prosthetic iris devices&#44; while reducing postoperative photophobic symptoms in patients with congenital aniridia and cataract&#44; may be associated with postoperative secondary glaucoma and long-term corneal endothelial decompensation&#44;<a class="elsevierStyleCrossRefs" href="#bib0175"><span class="elsevierStyleSup">35&#8211;39</span></a> highlighting the need for longer-term follow-up studies as well as specific guidelines and protocols on selection criteria&#46; When considering the use of black diaphragm IOLs&#44; we must also emphasise the importance of differentiating these prosthetic devices that received European certification <span class="elsevierStyleItalic">&#40;Conformit&#233; Europ&#233;enne certificate&#41;</span> in 2011 and FDA approval in 2018 from other discredited devices having only a cosmetic function&#44; leading to severe complications with devastating visual consequences&#44;<a class="elsevierStyleCrossRef" href="#bib0200"><span class="elsevierStyleSup">40</span></a> making them unsuitable for implantation in the anterior chamber of the eye for cosmetic purposes&#46;<a class="elsevierStyleCrossRef" href="#bib0205"><span class="elsevierStyleSup">41</span></a></p><p id="par0155" class="elsevierStylePara elsevierViewall">Corneal tattooing &#40;keratopigmentation &#91;KTP&#93;&#41; is a surgical tool that has been used for many decades sporadically for the management of cosmetic problems related to blind eyes&#44; until it was extensively researched and developed by our team&#46; Modern KTP techniques allow for adequate cosmetic and functional results in the treatment of corneal leucomas&#44; mild functional disabilities caused by moderate to severe iris defects&#44; and elective eye colour change&#46;<a class="elsevierStyleCrossRefs" href="#bib0210"><span class="elsevierStyleSup">42&#8211;46</span></a> The use of new and extensively studied micronised mineral pigments&#44; with experimental evidence on their tolerability and toxicity&#44;<a class="elsevierStyleCrossRefs" href="#bib0235"><span class="elsevierStyleSup">47&#44;48</span></a> presents an additional advantage over other natural pigments because their particle size is decreased by micronisation procedures and reduces the possibility of developing a foreign body reaction against the pigment being injected into the corneal stroma&#46; KTP has the main advantage of being non-invasive in the sense that it is not intraocular and can be performed without requiring lens removal or without the need for adequate intraocular visibility&#44; as is the case with intraocular techniques&#46; It therefore has a fundamental role in the management of patients with aniridia&#44; but will be of lesser importance in the context of combined cataract surgery with aniridia&#46;</p></span><span id="sec0040" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0060">Conclusions</span><p id="par0160" class="elsevierStylePara elsevierViewall">In most cases of aniridia&#44; lens opacities progress during the first two decades of life to become subcapsular&#44; lamellar or cortical cataracts&#46; Although usually slow&#44; their gradual extension with age or the development of a nuclear component often justifies surgical indication between the third and fifth decades&#44; apart from rapidly progressing and subluxated cases&#46;</p><p id="par0165" class="elsevierStylePara elsevierViewall">When congenital cataracts severely affect the transparency of the eye&#44; extraction before the age of 3 months has been recommended to avoid sensory deprivation nystagmus&#46; However&#44; it is not easy to determine the potential benefit of early removal&#44; as nystagmus is also common in cases of aniridia without cataract&#44; and especially considering the possible complications&#46; In the presence of media opacity&#44; assessment of the status of the macula and optic nerve &#40;and thus of potential visual acuity&#41; is difficult&#44; and even the information that can be obtained by electrophysiological tests is often of limited usefulness&#46; In any case&#44; extreme caution should be exercised when indicating surgery due to the strong inflammatory and cicatricial reaction of ocular tissues in aniridia in general and particularly in infants&#46;</p></span><span id="sec0045" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0065">Funding</span><p id="par0170" class="elsevierStylePara elsevierViewall">This studay was partially funded by the <span class="elsevierStyleGrantSponsor" id="gs0005">Instituto de Salud Carlos III&#47;State Research Agency</span> and by the <span class="elsevierStyleGrantSponsor" id="gs0010">European Regional Development Fund</span>&#40;ERDF&#41; &#8220;Una manera de hacer Europa&#8221;&#46; Thematic Network of Cooperative Health Research OFTARED&#44; reference RD16&#47;0008&#47;0012&#46;</p></span><span id="sec0050" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0070">Conflict of interest</span><p id="par0175" class="elsevierStylePara elsevierViewall">No conflicts of interest have been declared by the authors&#46;</p></span></span>"
    "textoCompletoSecciones" => array:1 [
      "secciones" => array:12 [
        0 => array:3 [
          "identificador" => "xres1614990"
          "titulo" => "Abstract"
          "secciones" => array:1 [
            0 => array:1 [
              "identificador" => "abst0005"
            ]
          ]
        ]
        1 => array:2 [
          "identificador" => "xpalclavsec1443666"
          "titulo" => "Keywords"
        ]
        2 => array:3 [
          "identificador" => "xres1614989"
          "titulo" => "Resumen"
          "secciones" => array:1 [
            0 => array:1 [
              "identificador" => "abst0010"
            ]
          ]
        ]
        3 => array:2 [
          "identificador" => "xpalclavsec1443665"
          "titulo" => "Palabras clave"
        ]
        4 => array:2 [
          "identificador" => "sec0005"
          "titulo" => "Introduction"
        ]
        5 => array:3 [
          "identificador" => "sec0010"
          "titulo" => "Cataract phenotypes"
          "secciones" => array:3 [
            0 => array:2 [
              "identificador" => "sec0015"
              "titulo" => "Transparency alterations"
            ]
            1 => array:2 [
              "identificador" => "sec0020"
              "titulo" => "Position alterations"
            ]
            2 => array:2 [
              "identificador" => "sec0025"
              "titulo" => "Size and shape alterations"
            ]
          ]
        ]
        6 => array:2 [
          "identificador" => "sec0030"
          "titulo" => "Cataract genomics in aniridia"
        ]
        7 => array:2 [
          "identificador" => "sec0035"
          "titulo" => "Indications and surgical management"
        ]
        8 => array:2 [
          "identificador" => "sec0040"
          "titulo" => "Conclusions"
        ]
        9 => array:2 [
          "identificador" => "sec0045"
          "titulo" => "Funding"
        ]
        10 => array:2 [
          "identificador" => "sec0050"
          "titulo" => "Conflict of interest"
        ]
        11 => array:1 [
          "titulo" => "References"
        ]
      ]
    ]
    "pdfFichero" => "main.pdf"
    "tienePdf" => true
    "fechaRecibido" => "2020-10-27"
    "fechaAceptado" => "2020-12-15"
    "PalabrasClave" => array:2 [
      "en" => array:1 [
        0 => array:4 [
          "clase" => "keyword"
          "titulo" => "Keywords"
          "identificador" => "xpalclavsec1443666"
          "palabras" => array:6 [
            0 => "Aniridia"
            1 => "Cataracts"
            2 => "Congenital defects"
            3 => "Corneal tattoo"
            4 => "Keratopigmentation"
            5 => "Prosthetic iris devices"
          ]
        ]
      ]
      "es" => array:1 [
        0 => array:4 [
          "clase" => "keyword"
          "titulo" => "Palabras clave"
          "identificador" => "xpalclavsec1443665"
          "palabras" => array:6 [
            0 => "Aniridia"
            1 => "Catarata"
            2 => "Alteraciones cong&#233;nitas"
            3 => "Tatuaje corneal"
            4 => "Queratopigmentaci&#243;n"
            5 => "Dispositivos prot&#233;sicos de iris"
          ]
        ]
      ]
    ]
    "tieneResumen" => true
    "resumen" => array:2 [
      "en" => array:2 [
        "titulo" => "Abstract"
        "resumen" => "<span id="abst0005" class="elsevierStyleSection elsevierViewall"><p id="spar0095" class="elsevierStyleSimplePara elsevierViewall">Congenital aniridia is a rare genetic disease associated with mutations in the PAX6 gene&#46; Changes in the lens in aniridia can be alterations of size and shape&#44; of position &#8211; which generally reveal zonular weakness and determines subluxation of the lens &#8211; and mainly changes in transparency&#44; cataracts&#44; with variable morphology of polar&#44; cortical&#44; subcapsular&#44; lamellar&#44; and more rarely&#44; nuclear cataract&#46; Visual acuity and quality of vision in patients with congenital aniridia complicated by cataracts can be improved by carefully planned surgery&#44; when lack of media transparency justifies surgical indication&#46; Most patients have some improvement in visual acuity and quality of retinal image&#46; Cataract surgery with aniridia is complicated by pathological changes due to the underlying cause of the aniridia&#46; Challenges include corneal opacification&#44; friable capsule and&#44; above all&#44; iris and pupil reconstruction&#46; It can also determine late complications&#44; such as secondary glaucoma or deterioration of pre-existent glaucoma&#44; and corneal endothelial decompensation&#46; After crystalline lens surgery in these patients&#44; either by cataract or dislocation&#44; for visual rehabilitation there are various techniques such as keratopigmentation&#44; prosthetic iris devices or Morcher intraocular lenses with a black diaphragm&#46; An appropriate individualised surgical plan should be selected depending on patient and surgical experience&#44; in order to minimise complications and give the best chance of postoperative success&#46;</p></span>"
      ]
      "es" => array:2 [
        "titulo" => "Resumen"
        "resumen" => "<span id="abst0010" class="elsevierStyleSection elsevierViewall"><p id="spar0100" class="elsevierStyleSimplePara elsevierViewall">La aniridia cong&#233;nita es una enfermedad gen&#233;tica rara asociada a mutaciones del gen PAX6&#46; Las alteraciones del cristalino en aniridia pueden ser de tama&#241;o y forma&#44; de posici&#243;n &#8211; que en general revelan debilidad zonular y posible subluxaci&#243;n del cristalino &#8211; y principalmente alteraciones de transparencia&#46; Pueden presentar cataratas con morfolog&#237;a variable desde polares&#44; corticales&#44; subcapsulares y lamelares hasta m&#225;s infrecuentemente nucleares&#46; La agudeza visual y la calidad de la visi&#243;n en pacientes con aniridia cong&#233;nita asociada a cataratas se pueden mejorar mediante una cirug&#237;a cuidadosamente planificada cuando la falta de transparencia de los medios justifique la indicaci&#243;n quir&#250;rgica&#46; La cirug&#237;a de cataratas con aniridia se complica por alteraciones patol&#243;gicas asociadas a la aniridia&#46; Los desaf&#237;os incluyen opacificaci&#243;n corneal&#44; c&#225;psula friable y sobre todo reconstrucci&#243;n de iris y pupila&#59; adem&#225;s&#44; pueden aparecer complicaciones tard&#237;as como glaucoma secundario o deterioro de glaucoma preexistente y descompensaci&#243;n endotelial corneal&#46; Tras la cirug&#237;a cristaliniana en estos pacientes&#44; bien por catarata o luxaci&#243;n&#44; para la rehabilitaci&#243;n visual existen diversas t&#233;cnicas como la queratopigmentaci&#243;n&#44; los dispositivos prot&#233;sicos iridianos o las lentes de Morcher con diafragma negro&#46; Debe seleccionarse un m&#233;todo quir&#250;rgico individualizado&#44; seg&#250;n el paciente y la experiencia quir&#250;rgica&#44; que sea apropiado para minimizar las complicaciones y obtener mayores tasas de &#233;xito postoperatorio&#46;</p></span>"
      ]
    ]
    "NotaPie" => array:1 [
      0 => array:2 [
        "etiqueta" => "&#9734;"
        "nota" => "<p class="elsevierStyleNotepara" id="npar0005">Please cite this article as&#58; D&#8217;Oria F&#44; Barraquer R&#44; Alio JL&#46; Alteraciones del cristalino en la aniridia cong&#233;nita&#46; Arch Soc Esp Oftalmol&#46; 2021&#59;96&#40;S1&#41;&#58;38&#8211;51&#46;</p>"
      ]
    ]
    "multimedia" => array:17 [
      0 => array:8 [
        "identificador" => "fig0005"
        "etiqueta" => "Fig&#46; 1"
        "tipo" => "MULTIMEDIAFIGURA"
        "mostrarFloat" => true
        "mostrarDisplay" => false
        "figura" => array:1 [
          0 => array:4 [
            "imagen" => "gr1.jpeg"
            "Alto" => 1601
            "Ancho" => 2167
            "Tamanyo" => 246772
          ]
        ]
        "detalles" => array:1 [
          0 => array:3 [
            "identificador" => "at0005"
            "detalle" => "Fig&#46; "
            "rol" => "short"
          ]
        ]
        "descripcion" => array:1 [
          "en" => "<p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">A 10 year-old girl with complete aniridia and lenses described as &#8220;transparent&#8221;&#44; although there is a punctate posterior polar opacity in RE and a small peripheral anterior cortical plaque in LE&#46; Note the incipient bilateral inferior zonular distension&#46; The patient has glaucoma that required surgical treatment with a valve implant in the left eye&#46;</p>"
        ]
      ]
      1 => array:8 [
        "identificador" => "fig0010"
        "etiqueta" => "Fig&#46; 2"
        "tipo" => "MULTIMEDIAFIGURA"
        "mostrarFloat" => true
        "mostrarDisplay" => false
        "figura" => array:1 [
          0 => array:4 [
            "imagen" => "gr2.jpeg"
            "Alto" => 1117
            "Ancho" => 1583
            "Tamanyo" => 143715
          ]
        ]
        "detalles" => array:1 [
          0 => array:3 [
            "identificador" => "at0010"
            "detalle" => "Fig&#46; "
            "rol" => "short"
          ]
        ]
        "descripcion" => array:1 [
          "en" => "<p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">IOP of a 4 year-old boy with bilateral incomplete aniridia&#44; clear lens and VA&#160;&#60;&#160;0&#46;1&#44; due to possible foveal hypoplasia&#46; IOP was normal &#40;the central white spot is a reflection of the flash&#41;&#46;</p>"
        ]
      ]
      2 => array:8 [
        "identificador" => "fig0015"
        "etiqueta" => "Fig&#46; 3"
        "tipo" => "MULTIMEDIAFIGURA"
        "mostrarFloat" => true
        "mostrarDisplay" => false
        "figura" => array:1 [
          0 => array:4 [
            "imagen" => "gr3.jpeg"
            "Alto" => 1202
            "Ancho" => 1583
            "Tamanyo" => 151708
          ]
        ]
        "detalles" => array:1 [
          0 => array:3 [
            "identificador" => "at0015"
            "detalle" => "Fig&#46; "
            "rol" => "short"
          ]
        ]
        "descripcion" => array:1 [
          "en" => "<p id="spar0015" class="elsevierStyleSimplePara elsevierViewall">LE of a 6 year-old boy with bilateral complete aniridia and microspherophakia appearance&#46; The zonule has a weak and distended appearance&#46; The lenses were clear except for a punctate anterior polar opacity&#44; although he already had glaucoma &#40;see evolution in <a class="elsevierStyleCrossRef" href="#fig0070">Fig&#46; 14</a>&#41;&#46;</p>"
        ]
      ]
      3 => array:8 [
        "identificador" => "fig0020"
        "etiqueta" => "Fig&#46; 4"
        "tipo" => "MULTIMEDIAFIGURA"
        "mostrarFloat" => true
        "mostrarDisplay" => false
        "figura" => array:1 [
          0 => array:4 [
            "imagen" => "gr4.jpeg"
            "Alto" => 1889
            "Ancho" => 2917
            "Tamanyo" => 393137
          ]
        ]
        "detalles" => array:1 [
          0 => array:3 [
            "identificador" => "at0020"
            "detalle" => "Fig&#46; "
            "rol" => "short"
          ]
        ]
        "descripcion" => array:1 [
          "en" => "<p id="spar0020" class="elsevierStyleSimplePara elsevierViewall">Forms of anterior subcapsular cataract in aniridia&#46; Top left and centre&#58; flat anterior polar plaque of about 1&#160;mm&#44; isolated&#44; in a 22 year-old male&#46; Above right&#58; The same condition&#44; associated with coronary peripheral opacity in a 26-year-old woman&#46; Bottom&#58; central plaque of about 2&#46;5&#160;mm&#44; with peripheral circular enhancement&#44; in a 4 year-old girl who also presented with choroidal coloboma&#46;</p>"
        ]
      ]
      4 => array:8 [
        "identificador" => "fig0025"
        "etiqueta" => "Fig&#46; 5"
        "tipo" => "MULTIMEDIAFIGURA"
        "mostrarFloat" => true
        "mostrarDisplay" => false
        "figura" => array:1 [
          0 => array:4 [
            "imagen" => "gr5.jpeg"
            "Alto" => 1100
            "Ancho" => 2167
            "Tamanyo" => 181558
          ]
        ]
        "detalles" => array:1 [
          0 => array:3 [
            "identificador" => "at0025"
            "detalle" => "Fig&#46; "
            "rol" => "short"
          ]
        ]
        "descripcion" => array:1 [
          "en" => "<p id="spar0025" class="elsevierStyleSimplePara elsevierViewall">Anterior pyramidal cataract in a 5-year-old boy with aniridia&#44; showing remnants of the <span class="elsevierStyleItalic">tunica vascularis</span>&#46;</p>"
        ]
      ]
      5 => array:8 [
        "identificador" => "fig0030"
        "etiqueta" => "Fig&#46; 6"
        "tipo" => "MULTIMEDIAFIGURA"
        "mostrarFloat" => true
        "mostrarDisplay" => false
        "figura" => array:1 [
          0 => array:4 [
            "imagen" => "gr6.jpeg"
            "Alto" => 1614
            "Ancho" => 2167
            "Tamanyo" => 221431
          ]
        ]
        "detalles" => array:1 [
          0 => array:3 [
            "identificador" => "at0030"
            "detalle" => "Fig&#46; "
            "rol" => "short"
          ]
        ]
        "descripcion" => array:1 [
          "en" => "<p id="spar0030" class="elsevierStyleSimplePara elsevierViewall">A 17 year-old male with aniridia and IOP controlled with hypotensive eyedrops&#46; The RE has an &#8220;anterior polar&#8221; cataract&#44; actually a nodule just in front of the foveal nucleus with lamellar extensions arching backwards and others starting from the posterior pole of the foveal nucleus&#46; The LE has two plaques in the anterior cortex&#44; in a plane just in front of the nuclear interphase&#46;</p>"
        ]
      ]
      6 => array:8 [
        "identificador" => "fig0035"
        "etiqueta" => "Fig&#46; 7"
        "tipo" => "MULTIMEDIAFIGURA"
        "mostrarFloat" => true
        "mostrarDisplay" => false
        "figura" => array:1 [
          0 => array:4 [
            "imagen" => "gr7.jpeg"
            "Alto" => 1852
            "Ancho" => 2167
            "Tamanyo" => 291882
          ]
        ]
        "detalles" => array:1 [
          0 => array:3 [
            "identificador" => "at0035"
            "detalle" => "Fig&#46; "
            "rol" => "short"
          ]
        ]
        "descripcion" => array:1 [
          "en" => "<p id="spar0035" class="elsevierStyleSimplePara elsevierViewall">Female with WAGR syndrome who at least since the age of 2 exhibited posterior and anterior polar subcapsular opacities in BE&#46; She required glaucoma surgery in BE&#46; At the age of 25 the opacities in the LE had progressed a little &#40;top&#41;&#44; with discrete posterior peripheral extension&#44; while the RE &#40;bottom&#41; developed a diffuse cortical cataract in addition to the more dense axial opacities&#46;</p>"
        ]
      ]
      7 => array:8 [
        "identificador" => "fig0040"
        "etiqueta" => "Fig&#46; 8"
        "tipo" => "MULTIMEDIAFIGURA"
        "mostrarFloat" => true
        "mostrarDisplay" => false
        "figura" => array:1 [
          0 => array:4 [
            "imagen" => "gr8.jpeg"
            "Alto" => 1224
            "Ancho" => 2167
            "Tamanyo" => 154583
          ]
        ]
        "detalles" => array:1 [
          0 => array:3 [
            "identificador" => "at0040"
            "detalle" => "Fig&#46; "
            "rol" => "short"
          ]
        ]
        "descripcion" => array:1 [
          "en" => "<p id="spar0040" class="elsevierStyleSimplePara elsevierViewall">Partial aniridia associated with central posterior subcapsular opacity with satellites or peripheral branches in a 32 year-old female patient with a family history of aniridia in four generations&#46; There was mild powdery opacity in the embryonal nucleus&#46;</p>"
        ]
      ]
      8 => array:8 [
        "identificador" => "fig0045"
        "etiqueta" => "Fig&#46; 9"
        "tipo" => "MULTIMEDIAFIGURA"
        "mostrarFloat" => true
        "mostrarDisplay" => false
        "figura" => array:1 [
          0 => array:4 [
            "imagen" => "gr9.jpeg"
            "Alto" => 1737
            "Ancho" => 2167
            "Tamanyo" => 266215
          ]
        ]
        "detalles" => array:1 [
          0 => array:3 [
            "identificador" => "at0045"
            "detalle" => "Fig&#46; "
            "rol" => "short"
          ]
        ]
        "descripcion" => array:1 [
          "en" => "<p id="spar0045" class="elsevierStyleSimplePara elsevierViewall">Extensive posterior cortical or subcapsular cataract in two cases of complete aniridia&#46; Above&#44; a 13-year-old patient showing the coralliform or petaloid appearance with branches converging on an axial nodule&#44; both in direct light and under retroillumination&#46; Below&#44; in a 34-year-old patient the plane of the opacities appears subcortical&#44; like a posterior lamellar cataract&#46; In both cases there is some inferior predominance&#46;</p>"
        ]
      ]
      9 => array:8 [
        "identificador" => "fig0050"
        "etiqueta" => "Fig&#46; 10"
        "tipo" => "MULTIMEDIAFIGURA"
        "mostrarFloat" => true
        "mostrarDisplay" => false
        "figura" => array:1 [
          0 => array:4 [
            "imagen" => "gr10.jpeg"
            "Alto" => 1952
            "Ancho" => 2833
            "Tamanyo" => 393664
          ]
        ]
        "detalles" => array:1 [
          0 => array:3 [
            "identificador" => "at0050"
            "detalle" => "Fig&#46; 1"
            "rol" => "short"
          ]
        ]
        "descripcion" => array:1 [
          "en" => "<p id="spar0050" class="elsevierStyleSimplePara elsevierViewall">Four patients with aniridia and approximately annular cataract&#46; The opacities are located in the subcortical or zonular plane &#40;top left&#44; 17 year-old male&#59; centre&#44; 27 year-old female&#41;&#44; or in the deep portion of the equatorial cortex &#40;top right&#44; 33 year-old sister of the patient in <a class="elsevierStyleCrossRef" href="#fig0040">Fig&#46; 8</a>&#41;&#46; The axial region may be spared or have small opacities&#44; either posterior or anterior &#40;bottom&#44; female aged 34 years&#41;&#46;</p>"
        ]
      ]
      10 => array:8 [
        "identificador" => "fig0055"
        "etiqueta" => "Fig&#46; 11"
        "tipo" => "MULTIMEDIAFIGURA"
        "mostrarFloat" => true
        "mostrarDisplay" => false
        "figura" => array:1 [
          0 => array:4 [
            "imagen" => "gr11.jpeg"
            "Alto" => 1787
            "Ancho" => 2167
            "Tamanyo" => 253375
          ]
        ]
        "detalles" => array:1 [
          0 => array:3 [
            "identificador" => "at0055"
            "detalle" => "Fig&#46; 1"
            "rol" => "short"
          ]
        ]
        "descripcion" => array:1 [
          "en" => "<p id="spar0055" class="elsevierStyleSimplePara elsevierViewall">12 year-old boy with aniridia&#44; cataracts seen at birth&#44; glaucoma and psychomotor retardation&#46; Renal alterations were excluded&#46; There is no family history but there is paternal consanguinity&#46; The opacity seems to be limited to the foveal nucleus of the lens&#46;</p>"
        ]
      ]
      11 => array:8 [
        "identificador" => "fig0060"
        "etiqueta" => "Fig&#46; 12"
        "tipo" => "MULTIMEDIAFIGURA"
        "mostrarFloat" => true
        "mostrarDisplay" => false
        "figura" => array:1 [
          0 => array:4 [
            "imagen" => "gr12.jpeg"
            "Alto" => 1228
            "Ancho" => 2167
            "Tamanyo" => 160657
          ]
        ]
        "detalles" => array:1 [
          0 => array:3 [
            "identificador" => "at0060"
            "detalle" => "Fig&#46; 1"
            "rol" => "short"
          ]
        ]
        "descripcion" => array:1 [
          "en" => "<p id="spar0060" class="elsevierStyleSimplePara elsevierViewall">Progression to nuclear cataract in two women with aniridia&#44; aged 41 &#40;left&#41; and 28 years &#40;right&#41;&#46; The first&#44; with a moderately brunescent nucleus&#44; previously had only small subcortical or lamellar opacities&#46; The second&#44; with an opalescent nucleus&#44; previously had a dense central posterior subcapsular plaque and is a carrier of a limbal annular homograft&#46; Note the incipient subluxation in both&#46;</p>"
        ]
      ]
      12 => array:8 [
        "identificador" => "fig0065"
        "etiqueta" => "Fig&#46; 13"
        "tipo" => "MULTIMEDIAFIGURA"
        "mostrarFloat" => true
        "mostrarDisplay" => false
        "figura" => array:1 [
          0 => array:4 [
            "imagen" => "gr13.jpeg"
            "Alto" => 1691
            "Ancho" => 2167
            "Tamanyo" => 264270
          ]
        ]
        "detalles" => array:1 [
          0 => array:3 [
            "identificador" => "at0065"
            "detalle" => "Fig&#46; 1"
            "rol" => "short"
          ]
        ]
        "descripcion" => array:1 [
          "en" => "<p id="spar0065" class="elsevierStyleSimplePara elsevierViewall">Four forms of advanced cataract progression in aniridia&#46; Top left&#58; 40-year-old woman with diffuse cortical opacity and discretely opalescent nucleus&#46; Above right&#58; 19-year-old woman who experienced rapid vision loss and intumescent cataract&#46; The fellow eye&#44; which at the time had only small subcortical opacities&#44; developed the same appearance 6 months later&#46; Bottom left&#58; 45 year-old woman with significant irregular opacity and signs of partial resorption&#46; Bottom right&#58; 44 year-old man with mature cortico-nuclear cataract&#44; very brunescent nucleus and subluxation&#46;</p>"
        ]
      ]
      13 => array:8 [
        "identificador" => "fig0070"
        "etiqueta" => "Fig&#46; 14"
        "tipo" => "MULTIMEDIAFIGURA"
        "mostrarFloat" => true
        "mostrarDisplay" => false
        "figura" => array:1 [
          0 => array:4 [
            "imagen" => "gr14.jpeg"
            "Alto" => 2086
            "Ancho" => 3333
            "Tamanyo" => 524176
          ]
        ]
        "detalles" => array:1 [
          0 => array:3 [
            "identificador" => "at0070"
            "detalle" => "Fig&#46; 1"
            "rol" => "short"
          ]
        ]
        "descripcion" => array:1 [
          "en" => "<p id="spar0070" class="elsevierStyleSimplePara elsevierViewall">Evolution of the patient in <a class="elsevierStyleCrossRef" href="#fig0015">Fig&#46; 3</a> with development of opacities&#44; while the subluxation does not seem to increase significantly&#46; Top&#58; BE appearance at the age of 21 years&#59; cortical opacities have appeared in the inferior sectors&#46; Middle row&#58; the LE at age 27&#44; with progression of cortical opacities and development of opalescent nuclear cataract&#46; Bottom&#58; the RE at age 35&#44; with cortical cataract&#44; more diffuse but nucleus still transparent&#59; the densest opacity coincides with the area of greatest subluxation&#44; as revealed by retroillumination&#46; Bottom right&#58; the LE with diaphragm IOL implantation&#46;</p>"
        ]
      ]
      14 => array:8 [
        "identificador" => "fig0075"
        "etiqueta" => "Fig&#46; 15"
        "tipo" => "MULTIMEDIAFIGURA"
        "mostrarFloat" => true
        "mostrarDisplay" => false
        "figura" => array:1 [
          0 => array:4 [
            "imagen" => "gr15.jpeg"
            "Alto" => 869
            "Ancho" => 2167
            "Tamanyo" => 148167
          ]
        ]
        "detalles" => array:1 [
          0 => array:3 [
            "identificador" => "at0075"
            "detalle" => "Fig&#46; 1"
            "rol" => "short"
          ]
        ]
        "descripcion" => array:1 [
          "en" => "<p id="spar0075" class="elsevierStyleSimplePara elsevierViewall">Both eyes of this 2 month-old boy had subtotal aniridia&#44; finely vascularised corneal opacity throughout the lower nasal quadrant and corneal adhesion to the lens in this area&#44; although the lens was still transparent&#46; Note the persistence of remnants of the <span class="elsevierStyleItalic">tunica vasculosa lentis</span>&#46;</p>"
        ]
      ]
      15 => array:8 [
        "identificador" => "fig0080"
        "etiqueta" => "Fig&#46; 16"
        "tipo" => "MULTIMEDIAFIGURA"
        "mostrarFloat" => true
        "mostrarDisplay" => false
        "figura" => array:1 [
          0 => array:4 [
            "imagen" => "gr16.jpeg"
            "Alto" => 1229
            "Ancho" => 2167
            "Tamanyo" => 161885
          ]
        ]
        "detalles" => array:1 [
          0 => array:3 [
            "identificador" => "at0080"
            "detalle" => "Fig&#46; 1"
            "rol" => "short"
          ]
        ]
        "descripcion" => array:1 [
          "en" => "<p id="spar0080" class="elsevierStyleSimplePara elsevierViewall">Two different patients with aniridia and crystalline lenses &#8211; with only small opacities &#8211; in which the anterior curvature appears increased&#44; greater than the posterior curvature&#46; Hardly any subluxation is visible&#46;</p>"
        ]
      ]
      16 => array:8 [
        "identificador" => "tbl0005"
        "etiqueta" => "Table 1"
        "tipo" => "MULTIMEDIATABLA"
        "mostrarFloat" => true
        "mostrarDisplay" => false
        "detalles" => array:1 [
          0 => array:3 [
            "identificador" => "at0085"
            "detalle" => "Table "
            "rol" => "short"
          ]
        ]
        "tabla" => array:2 [
          "leyenda" => "<p id="spar0090" class="elsevierStyleSimplePara elsevierViewall">CTR&#58; capsular tension ring&#59; ECCE&#58; extracapsular cataract surgery&#59; IOL&#58; intraocular lens&#59; NR&#58; not reported&#46;</p>"
          "tablatextoimagen" => array:1 [
            0 => array:2 [
              "tabla" => array:1 [
                0 => """
                  <table border="0" frame="\n
                  \t\t\t\t\tvoid\n
                  \t\t\t\t" class=""><thead title="thead"><tr title="table-row"><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Author &#91;year&#93;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="center" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Country&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="center" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Cataract and aniridia patients&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="center" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Type of operation&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="center" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Mean age&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="center" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Visual results&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="center" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Complications&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead rowgroup " rowspan="3" align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Reinard et al&#46; &#91;2000&#93;&#46;</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " rowspan="3" align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Germany</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " rowspan="3" align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">17 patients &#40;19 eyes&#41;</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">10 eyes&#58; ECCE&#59;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " rowspan="3" align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">30 years &#40;range&#58; 10&#8211;59&#41;</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " rowspan="3" align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Improvement in 14 eyes&#44; no change in one eye&#44; deterioration in 4 eyes</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">4 eyes with glaucoma deterioration &#40;2 with medical treatment and 2 with surgery&#41;&#59;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">9 eyes&#58; phacoemulsification&#46;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">4 eyes <span class="elsevierStyleItalic">ex novo</span> glaucoma &#40;2 with medical treatment and 2 with surgery&#41;&#59;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">All&#58; Black diaphragm IOL implant&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">3 eyes endothelial cell loss&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead rowgroup " rowspan="3" align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Park et al&#46; &#91;2010&#93;&#46;</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " rowspan="3" align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Korea</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " rowspan="3" align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">33 eyes</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " rowspan="3" align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">8 eyes&#58; phacoemulsification and IOL implantation</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " rowspan="3" align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">29&#46;8 years</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " rowspan="3" align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Improvement in all</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">4 eyes glaucoma deterioration&#59;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">4 eyes corneal edema&#59;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">4 eyes corneal transplant&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead rowgroup " rowspan="3" align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Eden et al&#46; &#91;2014&#93;&#46;</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " rowspan="3" align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Norway</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " rowspan="3" align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">26 Patients &#40;52 eyes&#41;</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">13 eyes&#58; cataract surgery&#59;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " rowspan="3" align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">29 years &#40;range&#58; 4&#8211;63&#41;</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " rowspan="3" align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">NR</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " rowspan="3" align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">30&#37; associated keratopathy</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">8 eyes&#58; cataract and glaucoma surgery&#59;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">4 eyes&#58; glaucoma surgery&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead rowgroup " rowspan="2" align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Chang et al&#46; &#91;2014&#93;&#46;</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " rowspan="2" align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Korea</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " rowspan="2" align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">63 eyes</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">4 eyes cataract surgery&#59;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " rowspan="2" align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">31 months &#40;range&#58; 6&#8211;66&#41;</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " rowspan="2" align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Improvement in 4 eyes with primary IOL implantation&#59; no improvement in the others&#46;</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " rowspan="2" align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">6 eyes glaucoma &#40;of which 4 treated with surgery&#41;</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">11 eyes cataract surgery and IOL implantation&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Shiple et al&#46; &#91;2015&#93;&#46;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">United States&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">99 patients&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">32 patients&#58; cataract surgery&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">28&#46;4 years &#40;range&#58; 4&#8211;51&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">NR&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">NR&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Wang et al&#46; &#91;2017&#93;&#46;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">China&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">10 patients &#40;17 eyes&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">17 eyes&#58; phacoemulsification with yellow IOL implantation and TCA&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">25&#46;4 years &#40;range&#58; 4&#8211;50&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Improvement in all&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">None&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr></tbody></table>
                  """
              ]
              "imagenFichero" => array:1 [
                0 => "xTab2753642.png"
              ]
            ]
          ]
        ]
        "descripcion" => array:1 [
          "en" => "<p id="spar0085" class="elsevierStyleSimplePara elsevierViewall">Demographic characteristics&#44; visual outcomes and complications of the main studies on patients with cataract and congenital aniridia&#46;</p>"
        ]
      ]
    ]
    "bibliografia" => array:2 [
      "titulo" => "References"
      "seccion" => array:1 [
        0 => array:2 [
          "identificador" => "bibs0005"
          "bibliografiaReferencia" => array:48 [
            0 => array:3 [
              "identificador" => "bib0005"
              "etiqueta" => "1"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Genomic structure&#44; evolutionary conservation and aniridia mutations in the human PAX6 gene"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:3 [
                            0 => "T&#46; Glaser"
                            1 => "D&#46;S&#46; Walton"
                            2 => "R&#46;L&#46; Maas"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1038/ng1192-232"
                      "Revista" => array:6 [
                        "tituloSerie" => "Nat Genet"
                        "fecha" => "1992"
                        "volumen" => "2"
                        "paginaInicial" => "232"
                        "paginaFinal" => "239"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/1345175"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            1 => array:3 [
              "identificador" => "bib0010"
              "etiqueta" => "2"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Two Paired Box 6 mutations identified in Chinese patients with classic congenital aniridia and cataract"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "Y&#46; Lin"
                            1 => "H&#46; Gao"
                            2 => "Y&#46; Zhu"
                            3 => "v C&#46; Chen"
                            4 => "T&#46; Li"
                            5 => "B&#46; Liu"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.3892/mmr.2018.9469"
                      "Revista" => array:5 [
                        "tituloSerie" => "Mol Med Rep"
                        "fecha" => "2018"
                        "volumen" => "18"
                        "paginaInicial" => "4439"
                        "paginaFinal" => "4445"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            2 => array:3 [
              "identificador" => "bib0015"
              "etiqueta" => "3"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Aniridia&#58; a review"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:5 [
                            0 => "L&#46;B&#46; Nelson"
                            1 => "G&#46;L&#46; Speaeth"
                            2 => "T&#46;S&#46; Nowinski"
                            3 => "C&#46;E&#46; Margo"
                            4 => "L&#46; Jackson"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1016/0039-6257(84)90184-x"
                      "Revista" => array:6 [
                        "tituloSerie" => "Surv Ophthalmol"
                        "fecha" => "1984"
                        "volumen" => "28"
                        "paginaInicial" => "621"
                        "paginaFinal" => "642"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/6330922"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            3 => array:3 [
              "identificador" => "bib0020"
              "etiqueta" => "4"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Clinical features of Korean patients with congenital aniridia"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:4 [
                            0 => "S&#46;H&#46; Park"
                            1 => "Y&#46;G&#46; Park"
                            2 => "M&#46;Y&#46; Lee"
                            3 => "M&#46;S&#46; Kim"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.3341/kjo.2010.24.5.291"
                      "Revista" => array:6 [
                        "tituloSerie" => "Korean J Ophthalmol"
                        "fecha" => "2010"
                        "volumen" => "24"
                        "paginaInicial" => "291"
                        "paginaFinal" => "296"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/21052509"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            4 => array:3 [
              "identificador" => "bib0025"
              "etiqueta" => "5"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Cataract development in Norwegian patients with congenital aniridia"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "U&#46; Ed&#233;n"
                            1 => "N&#46; Lagali"
                            2 => "A&#46; Dellby"
                            3 => "T&#46;P&#46; Utheim"
                            4 => "R&#46; Riise"
                            5 => "X&#46; Chen"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1111/aos.12225"
                      "Revista" => array:6 [
                        "tituloSerie" => "Acta Ophthalmol"
                        "fecha" => "2014"
                        "volumen" => "92"
                        "paginaInicial" => "e165"
                        "paginaFinal" => "e167"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/23826968"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            5 => array:3 [
              "identificador" => "bib0030"
              "etiqueta" => "6"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Ocular and nonocular findings in patients with aniridia"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:2 [
                            0 => "A&#46; Valenzuela"
                            1 => "R&#46;A&#46; Cline"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1016/s0008-4182(04)80028-0"
                      "Revista" => array:6 [
                        "tituloSerie" => "Can J Ophthalmol"
                        "fecha" => "2004"
                        "volumen" => "39"
                        "paginaInicial" => "632"
                        "paginaFinal" => "638"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/15559649"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            6 => array:3 [
              "identificador" => "bib0035"
              "etiqueta" => "7"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "A consideration of aniridia&#44; with a pedigree"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:1 [
                            0 => "P&#46;H&#46; Beattie"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1136/bjo.31.11.649"
                      "Revista" => array:5 [
                        "tituloSerie" => "Br J Ophthalmol"
                        "fecha" => "1947"
                        "volumen" => "31"
                        "paginaInicial" => "649"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/18170387"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            7 => array:3 [
              "identificador" => "bib0040"
              "etiqueta" => "8"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Progressive changes in the angle in congenital aniridia&#44; with development of glaucoma"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:2 [
                            0 => "W&#46;M&#46; Grant"
                            1 => "D&#46;S&#46; Walton"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1016/0002-9394(74)90308-0"
                      "Revista" => array:5 [
                        "tituloSerie" => "Am J Ophthalmol"
                        "fecha" => "1974"
                        "volumen" => "18"
                        "paginaInicial" => "842"
                        "paginaFinal" => "847"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            8 => array:3 [
              "identificador" => "bib0045"
              "etiqueta" => "9"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Ultrasound biomicroscopic findings in aniridia"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:5 [
                            0 => "F&#46; Okamoto"
                            1 => "S&#46; Nakano"
                            2 => "C&#46; Okamoto"
                            3 => "S&#46; Hommura"
                            4 => "T&#46; Oshika"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1016/j.ajo.2003.12.014"
                      "Revista" => array:6 [
                        "tituloSerie" => "Am J Ophthalmol"
                        "fecha" => "2004"
                        "volumen" => "137"
                        "paginaInicial" => "858"
                        "paginaFinal" => "862"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/15126150"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            9 => array:3 [
              "identificador" => "bib0050"
              "etiqueta" => "10"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Anterior segment dysgenesis keratolenticular adhesion and aniridia"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:1 [
                            0 => "G&#46;R&#46; Beauchamp"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "J Pediat Ophthalmol Strabismus"
                        "fecha" => "1978"
                        "volumen" => "17"
                        "paginaInicial" => "55"
                        "paginaFinal" => "58"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/6988567"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            10 => array:3 [
              "identificador" => "bib0055"
              "etiqueta" => "11"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Mutations at the PAX6 locus are found in heterogeneous anterior segment malformations including Peters&#8217; anomaly"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "I&#46;M&#46; Hanson"
                            1 => "J&#46;M&#46; Fletcher"
                            2 => "T&#46; Jordon"
                            3 => "A&#46; Brown"
                            4 => "D&#46; Taylor"
                            5 => "R&#46;J&#46; Adams"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1038/ng0294-168"
                      "Revista" => array:6 [
                        "tituloSerie" => "Nat Genet"
                        "fecha" => "1994"
                        "volumen" => "6"
                        "paginaInicial" => "168"
                        "paginaFinal" => "173"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/8162071"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            11 => array:3 [
              "identificador" => "bib0060"
              "etiqueta" => "12"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Abnormal lens shape on CT in a patient with aniridia"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:4 [
                            0 => "J&#46;S&#46; Mehta"
                            1 => "I&#46;F&#46; Moseley"
                            2 => "M&#46; Restori"
                            3 => "G&#46;T&#46; Plant"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1038/sj.eye.6700584"
                      "Revista" => array:6 [
                        "tituloSerie" => "Eye"
                        "fecha" => "2004"
                        "volumen" => "18"
                        "paginaInicial" => "209"
                        "paginaFinal" => "210"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/14762425"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            12 => array:3 [
              "identificador" => "bib0065"
              "etiqueta" => "13"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Membranous cataract in association with aniridia"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:3 [
                            0 => "K&#46; Yoshikawa"
                            1 => "H&#46; Asakage"
                            2 => "Y&#46; Inoue"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "Jpn J Ophthalmol"
                        "fecha" => "1993"
                        "volumen" => "37"
                        "paginaInicial" => "325"
                        "paginaFinal" => "329"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/8295372"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            13 => array:3 [
              "identificador" => "bib0070"
              "etiqueta" => "14"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Family with aniridia&#44; microcornea&#44; and spontaneously reabsorbed cataract"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:3 [
                            0 => "Y&#46; Yamamoto"
                            1 => "S&#46; Hayasaka"
                            2 => "T&#46; Setogawa"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1001/archopht.1988.01060130548033"
                      "Revista" => array:6 [
                        "tituloSerie" => "Arch Ophthalmol"
                        "fecha" => "1988"
                        "volumen" => "106"
                        "paginaInicial" => "502"
                        "paginaFinal" => "504"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/3355417"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            14 => array:3 [
              "identificador" => "bib0075"
              "etiqueta" => "15"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Autosomal dominant aniridia&#58; probable linkage to acid phosphatase-1 on chromosome 2"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:4 [
                            0 => "R&#46;E&#46; Ferrell"
                            1 => "A&#46; Chakravarti"
                            2 => "H&#46;M&#46; Hittner"
                            3 => "V&#46;M&#46; Riccardi"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1073/pnas.77.3.1580"
                      "Revista" => array:6 [
                        "tituloSerie" => "Proc Natl Acad Sci U S A"
                        "fecha" => "1980"
                        "volumen" => "77"
                        "paginaInicial" => "1580"
                        "paginaFinal" => "1582"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/6929510"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            15 => array:3 [
              "identificador" => "bib0080"
              "etiqueta" => "16"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Resolution of the two loci for autosomal dominant aniridia&#44; AN1 and AN2&#44; to a single locus on chromosome 11p13"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:5 [
                            0 => "L&#46;A&#46; Lyons"
                            1 => "A&#46; Martha"
                            2 => "H&#46;A&#46; Mintz-Hitter"
                            3 => "G&#46;F&#46; Saunders"
                            4 => "R&#46;E&#46; Ferrell"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1016/0888-7543(92)90002-a"
                      "Revista" => array:5 [
                        "tituloSerie" => "Genomics"
                        "fecha" => "1992"
                        "volumen" => "13"
                        "paginaInicial" => "925"
                        "paginaFinal" => "930"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            16 => array:3 [
              "identificador" => "bib0085"
              "etiqueta" => "17"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "A review of the clinical and genetic aspects of aniridia"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:2 [
                            0 => "H&#46;J&#46; Lee"
                            1 => "K&#46;A&#46; Colby"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.3109/08820538.2013.825293"
                      "Revista" => array:6 [
                        "tituloSerie" => "Semin Ophthalmol"
                        "fecha" => "2013"
                        "volumen" => "28"
                        "paginaInicial" => "306"
                        "paginaFinal" => "312"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/24138039"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            17 => array:3 [
              "identificador" => "bib0090"
              "etiqueta" => "18"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Three new PAX6 mutations including one causing an unusual ophthalmic phenotype associated with neurodevelopmental abnormalities"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "A&#46; Dansault"
                            1 => "G&#46; David"
                            2 => "C&#46; Schwartz"
                            3 => "C&#46; Jaliffa"
                            4 => "V&#46; Vieira"
                            5 => "G&#46; de la Houssaye"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "Mol Vis"
                        "fecha" => "2007"
                        "volumen" => "13"
                        "paginaInicial" => "511"
                        "paginaFinal" => "523"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/17417613"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            18 => array:3 [
              "identificador" => "bib0095"
              "etiqueta" => "19"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Pax6 lights-up the way for eye development"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:2 [
                            0 => "R&#46; Ashery-Padan"
                            1 => "P&#46; Gruss"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1016/s0955-0674(00)00274-x"
                      "Revista" => array:6 [
                        "tituloSerie" => "Curr Opin Cell Biol"
                        "fecha" => "2001"
                        "volumen" => "13"
                        "paginaInicial" => "706"
                        "paginaFinal" => "714"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/11698186"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            19 => array:3 [
              "identificador" => "bib0100"
              "etiqueta" => "20"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Pathways regulating lens induction in the mouse"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:1 [
                            0 => "R&#46;A&#46; Lang"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1387/ijdb.041903rl"
                      "Revista" => array:6 [
                        "tituloSerie" => "Int J Dev Biol"
                        "fecha" => "2004"
                        "volumen" => "48"
                        "paginaInicial" => "783"
                        "paginaFinal" => "791"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/15558471"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            20 => array:3 [
              "identificador" => "bib0105"
              "etiqueta" => "21"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Different roles for Pax6 in the optic vesicle and facial epithelium mediate early morphogenesis of the murine eye"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:3 [
                            0 => "J&#46;M&#46; Collinson"
                            1 => "R&#46;E&#46; Hill"
                            2 => "J&#46;D&#46; West"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "Development"
                        "fecha" => "2000"
                        "volumen" => "127"
                        "paginaInicial" => "945"
                        "paginaFinal" => "956"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/10662634"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            21 => array:3 [
              "identificador" => "bib0110"
              "etiqueta" => "22"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "The involvement of neural retina Pax6 in lens fiber differentiation"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:2 [
                            0 => "H&#46;M&#46; Reza"
                            1 => "K&#46; Yasuda"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1159/000082273"
                      "Revista" => array:6 [
                        "tituloSerie" => "Dev Neurosci"
                        "fecha" => "2004"
                        "volumen" => "26"
                        "paginaInicial" => "318"
                        "paginaFinal" => "327"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/15855760"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            22 => array:3 [
              "identificador" => "bib0115"
              "etiqueta" => "23"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Optic cup and lens development requires Pax6 expression in the early optic vesicle during a narrow time window"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:2 [
                            0 => "M&#46;V&#46; Canto-Soler"
                            1 => "R&#46; Adler"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1016/j.ydbio.2006.02.033"
                      "Revista" => array:6 [
                        "tituloSerie" => "Dev Biol"
                        "fecha" => "2006"
                        "volumen" => "294"
                        "paginaInicial" => "119"
                        "paginaFinal" => "132"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/16564518"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            23 => array:3 [
              "identificador" => "bib0120"
              "etiqueta" => "24"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Primary defects in the lens underlie complex anterior segment abnormalities of the Pax6 heterozygous eye"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "J&#46;M&#46; Collinson"
                            1 => "J&#46;C&#46; Quinn"
                            2 => "M&#46;A&#46; Buchanan"
                            3 => "M&#46;H&#46; Kaufman"
                            4 => "S&#46;E&#46; Wedden"
                            5 => "J&#46;D&#46; West"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1073/pnas.161144098"
                      "Revista" => array:6 [
                        "tituloSerie" => "Proc Natl Acad Sci U S A"
                        "fecha" => "2001"
                        "volumen" => "98"
                        "paginaInicial" => "9688"
                        "paginaFinal" => "9693"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/11481423"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            24 => array:3 [
              "identificador" => "bib0125"
              "etiqueta" => "25"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Prenatal diagnosis of aniridia"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:3 [
                            0 => "A&#46;J&#46; Churchill"
                            1 => "I&#46;M&#46; Hanson"
                            2 => "A&#46;F&#46; Markham"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1016/s0161-6420(00)00093-2"
                      "Revista" => array:6 [
                        "tituloSerie" => "Ophthalmology"
                        "fecha" => "2000"
                        "volumen" => "107"
                        "paginaInicial" => "1153"
                        "paginaFinal" => "1156"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/10857836"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            25 => array:3 [
              "identificador" => "bib0130"
              "etiqueta" => "26"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Clinical pathological study of the anterior lens capsule abnormalities in familial congenital aniridia with cataract"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:6 [
                            0 => "Z&#46;Q&#46; Hou"
                            1 => "Y&#46;S&#46; Hao"
                            2 => "W&#46; Wang"
                            3 => "Z&#46;Z&#46; Ma"
                            4 => "Y&#46;F&#46; Zhong"
                            5 => "S&#46;J&#46; Song"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "Beijing Da Xue Xue Bao"
                        "fecha" => "2005"
                        "volumen" => "37"
                        "paginaInicial" => "494"
                        "paginaFinal" => "497"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/16224520"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            26 => array:3 [
              "identificador" => "bib0135"
              "etiqueta" => "27"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Predicting cataract surgery results using a macular function test"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:4 [
                            0 => "J&#46;C&#46; Vryghem"
                            1 => "H&#46; Van Cleynenbreugel"
                            2 => "J&#46; Van Calster"
                            3 => "K&#46; Leroux"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1016/j.jcrs.2004.05.006"
                      "Revista" => array:6 [
                        "tituloSerie" => "J Cataract Refract Surg"
                        "fecha" => "2004"
                        "volumen" => "30"
                        "paginaInicial" => "2349"
                        "paginaFinal" => "2353"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/15519087"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            27 => array:3 [
              "identificador" => "bib0140"
              "etiqueta" => "28"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Thinning of the anterior capsule associated with congenital aniridia"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:5 [
                            0 => "S&#46; Schneider"
                            1 => "R&#46;H&#46; Osher"
                            2 => "S&#46;E&#46; Burk"
                            3 => "T&#46;B&#46; Lutz"
                            4 => "R&#46; Montione"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1016/s0886-3350(02)01602-4"
                      "Revista" => array:6 [
                        "tituloSerie" => "J Cataract Refract Surg&#46;"
                        "fecha" => "2003"
                        "volumen" => "29"
                        "paginaInicial" => "523"
                        "paginaFinal" => "525"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/12663018"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            28 => array:3 [
              "identificador" => "bib0145"
              "etiqueta" => "29"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "The long-term effect of in the bag implantation of capsular tension ring on posterior capsular opacification in cataract surgery"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:2 [
                            0 => "H&#46;J&#46; Kim"
                            1 => "S&#46;H&#46; Yoon"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:4 [
                        "tituloSerie" => "Ann Meet Abstr"
                        "fecha" => "2015"
                        "volumen" => "56"
                        "paginaInicial" => "889"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            29 => array:3 [
              "identificador" => "bib0150"
              "etiqueta" => "30"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Congenital aniridia with cataract&#58; case series"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "J&#46;D&#46; Wang"
                            1 => "J&#46;S&#46; Zhang"
                            2 => "Y&#46; Xiong"
                            3 => "J&#46; Li"
                            4 => "X&#46;X&#46; Li"
                            5 => "X&#46; Liu"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1186/s12886-017-0503-6"
                      "Revista" => array:5 [
                        "tituloSerie" => "BMC Ophthalmol"
                        "fecha" => "2017"
                        "volumen" => "17"
                        "paginaInicial" => "115"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/28676040"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            30 => array:3 [
              "identificador" => "bib0155"
              "etiqueta" => "31"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Treatment of congenital cataract accompanied by iridocoloboma"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:4 [
                            0 => "H&#46; Li"
                            1 => "J&#46;J&#46; Li"
                            2 => "Z&#46;L&#46; Hu"
                            3 => "C&#46;L&#46; Wei"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:5 [
                        "tituloSerie" => "Chin J Strabismus Pediatr Ophthalmol"
                        "fecha" => "2011"
                        "volumen" => "19"
                        "paginaInicial" => "58"
                        "paginaFinal" => "60"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            31 => array:3 [
              "identificador" => "bib0160"
              "etiqueta" => "32"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:1 [
                      "titulo" => "Pediatric ophthalmology and strabismus"
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "LibroEditado" => array:5 [
                        "editores" => "D&#46;Taylor, C&#46;Hoyt"
                        "titulo" => "Systematic pediatric ophthalmology"
                        "paginaInicial" => "401"
                        "edicion" => "3rd&#46; ed&#46;"
                        "serieFecha" => "2021"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            32 => array:3 [
              "identificador" => "bib0165"
              "etiqueta" => "33"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Surgery of the hereditary subluxated lens in children"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:2 [
                            0 => "M&#46; Halpert"
                            1 => "D&#46; BenEzra"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1016/s0161-6420(96)30633-7"
                      "Revista" => array:5 [
                        "tituloSerie" => "Ophthalmology"
                        "fecha" => "1996"
                        "volumen" => "103"
                        "paginaInicial" => "681"
                        "paginaFinal" => "686"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            33 => array:3 [
              "identificador" => "bib0170"
              "etiqueta" => "34"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Black diaphragm aniridia intraocular lens for congenital aniridia&#58; long-term follow-up"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:3 [
                            0 => "T&#46; Reinhard"
                            1 => "S&#46; Engelhardt"
                            2 => "R&#46; Sundmacher"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1016/s0886-3350(99)00432-0"
                      "Revista" => array:6 [
                        "tituloSerie" => "J Cataract Refract Surg"
                        "fecha" => "2000"
                        "volumen" => "26"
                        "paginaInicial" => "375"
                        "paginaFinal" => "381"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/10713232"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            34 => array:3 [
              "identificador" => "bib0175"
              "etiqueta" => "35"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Cataract surgery and aniridia"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:2 [
                            0 => "I&#46;M&#46; Neuhann"
                            1 => "T&#46;F&#46; Neuhann"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1097/ICU.0b013e328333ea49"
                      "Revista" => array:6 [
                        "tituloSerie" => "Curr Opin Ophthalmol"
                        "fecha" => "2010"
                        "volumen" => "21"
                        "paginaInicial" => "60"
                        "paginaFinal" => "64"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/19890208"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            35 => array:3 [
              "identificador" => "bib0180"
              "etiqueta" => "36"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Congenital aniridia&#58; long-term clinical course&#44; visual outcome&#44; and prognostic factors"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:4 [
                            0 => "J&#46;W&#46; Chang"
                            1 => "J&#46;H&#46; Kim"
                            2 => "S&#46;J&#46; Kim"
                            3 => "Y&#46;S&#46; Yu"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.3341/kjo.2014.28.6.479"
                      "Revista" => array:6 [
                        "tituloSerie" => "Korean J Ophthalmol"
                        "fecha" => "2014"
                        "volumen" => "28"
                        "paginaInicial" => "479"
                        "paginaFinal" => "485"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/25435751"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            36 => array:3 [
              "identificador" => "bib0185"
              "etiqueta" => "37"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Glaucoma and frequency of ocular and general diseases in 30 patients with aniridia&#58; a clinical study"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:3 [
                            0 => "E&#46; Gramer"
                            1 => "C&#46; Reiter"
                            2 => "G&#46; Gramer"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.5301/EJO.2011.8318"
                      "Revista" => array:5 [
                        "tituloSerie" => "Eur J Ophthalmol"
                        "fecha" => "2012"
                        "volumen" => "22"
                        "paginaInicial" => "104"
                        "paginaFinal" => "110"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            37 => array:3 [
              "identificador" => "bib0190"
              "etiqueta" => "38"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Black diaphragm intraocular lens in congenital aniridia"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:3 [
                            0 => "T&#46; Sundmacher"
                            1 => "T&#46; Reinhard"
                            2 => "C&#46; Althaus"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "Ger J Ophthalmol"
                        "fecha" => "1994"
                        "volumen" => "3"
                        "paginaInicial" => "197"
                        "paginaFinal" => "201"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/7804103"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            38 => array:3 [
              "identificador" => "bib0195"
              "etiqueta" => "39"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Black diaphragm intraocular lens implantation in patients with aniridia"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:1 [
                            0 => "S&#46;H&#46; Al-Rashidi"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.4103/jovr.jovr_244_17"
                      "Revista" => array:5 [
                        "tituloSerie" => "J Ophthalmic Vis Res"
                        "fecha" => "2019"
                        "volumen" => "14"
                        "paginaInicial" => "27"
                        "paginaFinal" => "31"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            39 => array:3 [
              "identificador" => "bib0200"
              "etiqueta" => "40"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Surgery of glaucoma in modern corneal graft procedures"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:3 [
                            0 => "A&#46; Abdelghany"
                            1 => "F&#46; D&#8217;Oria"
                            2 => "J&#46;L&#46; Alio"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1016/j.survophthal.2020.08.002"
                      "Revista" => array:2 [
                        "tituloSerie" => "Surv Ophthalm"
                        "fecha" => "2020"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            40 => array:3 [
              "identificador" => "bib0205"
              "etiqueta" => "41"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Postoperative results of cosmetic iris implants"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:3 [
                            0 => "V&#46; Galvis"
                            1 => "A&#46; Tello"
                            2 => "M&#46;I&#46; Corrales"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1016/j.jcrs.2016.08.013"
                      "Revista" => array:6 [
                        "tituloSerie" => "J Cataract Refract Surg"
                        "fecha" => "2016"
                        "volumen" => "42"
                        "paginaInicial" => "1518"
                        "paginaFinal" => "1526"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/27839608"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            41 => array:3 [
              "identificador" => "bib0210"
              "etiqueta" => "42"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Cosmetic keratopigmentation in sighted eyes&#58; medium and long-term clinical evaluation"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:5 [
                            0 => "F&#46; D&#8217;Oria"
                            1 => "J&#46;L&#46; Alio"
                            2 => "A&#46;E&#46; Rodriguez"
                            3 => "M&#46;A&#46; Amesty"
                            4 => "S&#46;K&#46; Abu-Mustafa"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1097/ICO.0000000000002417"
                      "Revista" => array:2 [
                        "tituloSerie" => "Cornea"
                        "fecha" => "2020"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            42 => array:3 [
              "identificador" => "bib0215"
              "etiqueta" => "43"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Keratopigmentation &#40;corneal tattooing&#41; for the management of visual disabilities of the eye related to iris defects"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:3 [
                            0 => "J&#46;L&#46; Alio"
                            1 => "A&#46;E&#46; Rodriguez"
                            2 => "B&#46;T&#46; Toffaha"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1136/bjophthalmol-2011-300170"
                      "Revista" => array:5 [
                        "tituloSerie" => "Br J Ophthalmol"
                        "fecha" => "2011"
                        "volumen" => "95"
                        "paginaInicial" => "1397"
                        "paginaFinal" => "1401"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            43 => array:3 [
              "identificador" => "bib0220"
              "etiqueta" => "44"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Femtosecond assisted keratopigmentation for functional and cosmetic restoration in essential iris atrophy"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:5 [
                            0 => "J&#46;L&#46; Ali&#243;"
                            1 => "A&#46;E&#46; Rodriguez"
                            2 => "B&#46;T&#46; Toffaha"
                            3 => "D&#46;P&#46; Pi&#241;ero"
                            4 => "L&#46;J&#46; Moreno"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1016/j.jcrs.2011.08.003"
                      "Revista" => array:6 [
                        "tituloSerie" => "J Cataract Refract Surg"
                        "fecha" => "2011"
                        "volumen" => "37"
                        "paginaInicial" => "1744"
                        "paginaFinal" => "1747"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/21865008"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            44 => array:3 [
              "identificador" => "bib0225"
              "etiqueta" => "45"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Superficial keratopigmentation&#58; an alternative solution for patients with cosmetically or functionally impaired eyes"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:4 [
                            0 => "O&#46; Al-Shymali"
                            1 => "A&#46;E&#46; Rodriguez"
                            2 => "M&#46;A&#46; Amesty"
                            3 => "J&#46;L&#46; Alio"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1097/ICO.0000000000001753"
                      "Revista" => array:6 [
                        "tituloSerie" => "Cornea"
                        "fecha" => "2019"
                        "volumen" => "38"
                        "paginaInicial" => "54"
                        "paginaFinal" => "61"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/30222713"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            45 => array:3 [
              "identificador" => "bib0230"
              "etiqueta" => "46"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Femtosecond laser-assisted superficial keratectomy for the treatment of superficial corneal leukomas"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:3 [
                            0 => "J&#46; Alio"
                            1 => "M&#46; Agdeppa"
                            2 => "A&#46; Uceda-Montanes"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1097/ICO.0b013e3181eeb0c1"
                      "Revista" => array:6 [
                        "tituloSerie" => "Cornea"
                        "fecha" => "2011"
                        "volumen" => "30"
                        "paginaInicial" => "301"
                        "paginaFinal" => "307"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/21045660"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            46 => array:3 [
              "identificador" => "bib0235"
              "etiqueta" => "47"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Tolerance of micronized mineral pigments for intrastromal keratopigmentation&#58; a histopathology and immunopathology experimental study"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:5 [
                            0 => "M&#46;A&#46; Amesty"
                            1 => "A&#46;E&#46; Rodriguez"
                            2 => "E&#46; Hern&#225;ndez"
                            3 => "M&#46;P&#46; de Miguel"
                            4 => "J&#46;L&#46; Alio"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1097/ICO.0000000000000900"
                      "Revista" => array:6 [
                        "tituloSerie" => "Cornea"
                        "fecha" => "2016"
                        "volumen" => "35"
                        "paginaInicial" => "1199"
                        "paginaFinal" => "1205"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/27261940"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            47 => array:3 [
              "identificador" => "bib0240"
              "etiqueta" => "48"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Corneal tolerance to micronised mineral pigments for keratopigmentation"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:3 [
                            0 => "M&#46;A&#46; Amesty"
                            1 => "J&#46;L&#46; Alio"
                            2 => "A&#46;E&#46; Rodriguez"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1136/bjophthalmol-2014-305611"
                      "Revista" => array:5 [
                        "tituloSerie" => "Br J Ophthalmol"
                        "fecha" => "2014"
                        "volumen" => "98"
                        "paginaInicial" => "1756"
                        "paginaFinal" => "1760"
                      ]
                    ]
                  ]
                ]
              ]
            ]
          ]
        ]
      ]
    ]
  ]
  "idiomaDefecto" => "en"
  "url" => "/21735794/00000096000000S1/v1_202111240624/S2173579421000773/v1_202111240624/en/main.assets"
  "Apartado" => array:4 [
    "identificador" => "58824"
    "tipo" => "SECCION"
    "en" => array:2 [
      "titulo" => "Reviews"
      "idiomaDefecto" => true
    ]
    "idiomaDefecto" => "en"
  ]
  "PDF" => "https://static.elsevier.es/multimedia/21735794/00000096000000S1/v1_202111240624/S2173579421000773/v1_202111240624/en/main.pdf?idApp=UINPBA00004N&text.app=https://www.elsevier.es/"
  "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S2173579421000773?idApp=UINPBA00004N"
]
Indexed in:

Follow us:

Subscribe:

Purchase article

Indexed in:

Follow us:

Subscribe:

Purchase article

Subscribe to our newsletter
