Case Report: Significant Complications of Cosmetic Iris Implantation
| Autor: | Eric N. Brown, Joshua L. Robinson, Jeremy B. Hatcher, Alexander de Castro-Abeger, Christine Shieh |
|---|---|
| Rok vydání: | 2021 |
| Předmět: |
Adult
Male medicine.medical_specialty genetic structures medicine.medical_treatment Ocular Pathology Visual Acuity Iris Glaucoma medicine Humans Iris (anatomy) Intraocular Pressure Corneal Decompensation business.industry Secondary glaucoma Corneal Edema Cataract surgery medicine.disease eye diseases Surgery Bilateral Cataracts Ophthalmology medicine.anatomical_structure sense organs business Uveitis Optometry |
| Zdroj: | Optometry and Vision Science. 98:886-890 |
| ISSN: | 1538-9235 1040-5488 |
| DOI: | 10.1097/opx.0000000000001752 |
| Popis: | Significance The complications of cosmetic iris implantation may result in irreversible vision loss. Patients who obtain these implants against general medical consensus may present to providers when sequelae develop. In symptomatic patients, providers must recognize the imminent risk to vision and mitigate further ocular damage. Purpose This is an observational clinical case report of a patient with significant, progressive, vision-threatening ocular pathology from prior cosmetic iris implantation, despite medical and surgical efforts to preserve vision. Case report A 35-year-old HIV-positive man with a history of cosmetic iris implants in India 16 months prior was referred to our center. He had a history of 4 months of steroid-refractory uveitis and secondary glaucoma, with IOP measurements of more than 50 mmHg in the outpatient setting. Slit-lamp examination revealed ciliary flush, pannus formation, corneal edema, and keratic precipitates. Optical coherence tomography suggested possible retinal nerve fiber layer loss in the left eye. He was diagnosed with uveitis and glaucoma, and after a short course of IOP-lowering medication, the implants were removed sequentially. Post-operatively, his course was complicated by IOP elevation, cataract development, and corneal decompensation. This led to bilateral Ahmed tube placement, Descemet's stripping endothelial keratoplasty of the right eye, and pending cataract surgery because of now-dense bilateral cataracts. Conclusions This case emphasizes the vision-threatening dangers of cosmetic iris implantation. It also demonstrates that sequelae may persist and develop despite implant removal and anticipatory management. Providers managing similar patients should carefully monitor for disease progression and maintain a low threshold for referral and/or decisive surgical intervention. |
| Databáze: | OpenAIRE |
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