Complications secondary to cosmetic artificial iris anterior chamber implants: a case report

Shweikh, Yusrah; Ameen, Sally; Mearza, Ali

doi:10.1186/s12886-015-0084-1

Cited by 9 publications

(13 citation statements)

References 13 publications

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“…V roce 2004 se na trhu v některých zemích objevily silikonové předněkomorové implantáty pod názvem NewCo-lorIris® (Kahn Medical Devices, Panama), které byly určeny ke zlepšení anatomického vzhledu duhovky pacientů s vrozenými vadami (např. okulokutánní albinismus) nebo posttraumatickými defekty duhovky [7,[22][23][24][25]. Jednalo se o silikonový, prstencový, jednodílný implantát o průměru 15 mm v tloušťce 0,16 mm s centrálním otvorem v zornici o průměru 3,50 mm a s šesti kotevními závěsy umístěnými v přímém kontaktu s duhovkou [22][23][24]26].…”

Section: Diskuzeunclassified

“…okulokutánní albinismus) nebo posttraumatickými defekty duhovky [7,[22][23][24][25]. Jednalo se o silikonový, prstencový, jednodílný implantát o průměru 15 mm v tloušťce 0,16 mm s centrálním otvorem v zornici o průměru 3,50 mm a s šesti kotevními závěsy umístěnými v přímém kontaktu s duhovkou [22][23][24]26]. Brzy však byly propagovány jako kosmetické předněkomorové implantáty, které byly zavedeny poprvé do praxe v roce 2006 v Panamě a zaměřovaly se na jedince přející si změnu barvy duhovky [11,[25][26][27][28].…”

Section: Diskuzeunclassified

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Artificial Cosmetic Iris – Potential Risk Of Visual Impairment. A Case Report

Baxant¹,

Veselý²,

Holubová³

et al. 2022

CSO

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In this paper, the authors present a case report of a 46–year–old patient with decompensated pigmentary glaucoma and anterior uveitis after unilateral implantation of a BrightOcular artificial cosmetic iris (Stellar Devices, New York, USA). Postoperatively, there was a decrease of endothelial cells (ECD) down to 1216 cells/mm2, a uveal reaction in the anterior chamber and a significant decompensation of intraocular pressure (IOP). During the first examination at our clinic, the explantation of the artificial cosmetic iris was indicated. However, despite all warnings, the patient repeatedly refused this procedure. The patient later decided to undergo the artificial cosmetic iris explantation due to persistent elevation of IOP with intense eye pain. The cosmetic iris implant was removed almost five months after its implantation. Postoperatively, the anterior uveitis resolved, but there was a further decrease in ECD of 130 cells/mm2 and also an increase in IOP, despite maximal antiglaucoma therapy. Nearly one month after removal of the artificial cosmetic iris, the patient underwent implantation of the Express P50 drainage shunt (Alcon Inc, Fort Worth, TX, USA). After the drainage procedure, IOP was normalized and remained within physiological limits during the first year after surgery. Thereafter, there was a recurrence of elevated IOP, which subsided to normal, after initiation of a combination of two antiglaucoma therapies. Four years after surgery the eye was quiescent, ECD stationary, the optic nerve head was stable, and the visual field remained within the physiological norm. This case report highlights a potentially harmful procedure that is presented as a relatively safe alternative for an iris colour change, representing a deceptive marketing strategy for companies trading in these implants.

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Section: Diskuzeunclassified

Artificial Cosmetic Iris – Potential Risk Of Visual Impairment. A Case Report

Baxant¹,

Veselý²,

Holubová³

et al. 2022

CSO

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“…The liberated pigment occludes the trabecular meshwork and rise IOP. Since ACIOL were promoted for their cosmetic use, there have been a growing number of cases with UGH [ 10 ].…”

Section: Pathophysiologymentioning

confidence: 99%

Uveitis–Glaucoma–Hyphaema Syndrome. General review

Zemba¹,

Camburu²

2017

rjo

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Uveitis-Glaucoma-Hyphaema Syndrome (UGH syndrome, or "Ellingson" Syndrome) is a rare condition caused by the mechanical trauma of an intraocular lens malpositioned over adjacent structures (iris, ciliary body, iridocorneal angle), leading to a spectrum of iris transillumination defects, microhyphaemas and pigmentary dispersion, concomitant with elevated intraocular pressure (IOP). UGH Syndrome can also be characterized by chronic inflammation, secondary iris neovascularization, cystoid macular edema (CME). The fundamental step in the pathogenesis of UGH syndrome appears to arise from repetitive mechanical iris trauma by a malpositioned or subluxed IOL. These patients have uncomplicated cataract implants and return for episodes of blurry vision weeks to months after surgery. This may be accompanied by pain, photophobia, erythropsia, anterior uveitis, hyphaema along with raised intraocular pressure. A careful history and examination, as well as appropriate investigations can confirm the diagnostic. Treatment options are IOL Explantation exchange, topical and systemic medication, and cyclophotocoagulation, the placement of a Capsular Tension Ring to redistribute zonular tension and Anti-vascular endothelial growth factor (anti-VEGF) Therapy.

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“…Consequently, direct damage to the uveal tissue and degradation of the blood-aqueous barrier results in episodic or chronic uveitis, pigment dispersion, iris transillumination defects (TIDs), hyphema, and microhyphemas, and is often associated with acute rise in intraocular pressure (IOP). UGH syndrome is most commonly associated with anterior chamber (AC) or iris-fixated intraocular lenses [ 1 , 2 , 3 ]; however, it has recently been reported in patients with posterior chamber intraocular lens (PCIOL) implants, ExPress shunts, and endocapsular tension rings [ 4 , 5 , 6 ].…”

Section: Introductionmentioning

confidence: 99%

Uveitis-Glaucoma-Hyphema Syndrome Following iStent Implantation

Siedlecki

Kinariwala²,

Sieminski³

2022

Case Rep Ophthalmol

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Minimally invasive glaucoma surgery (MIGS) is a subset of glaucoma surgery that is known for its low rate of complications both intraoperatively and postoperatively compared to traditional filtering surgery. We present a case of a patient who, after receiving uncomplicated cataract extraction with posterior chamber intraocular lens implantation and concurrent iStent trabecular bypass stent implantation, experienced recurrent episodes of spontaneous microhyphema and inflammation in the late postoperative period. The patient, who had a history of mild asymmetric exfoliative glaucoma but no identifiable sources of trauma, underwent extensive examination to investigate causes of his episodic anterior segment bleeding and mild inflammation with concurrent elevated intraocular pressure. Given the circumstances of the patient’s recurrent symptoms and a negative workup for conventional causes of recurrent hyphema, it was suspected that the patient’s iStent was interacting with the patient’s peripheral iris, causing microtrauma and hyphema. We hypothesized that this contact was potentially exacerbated by pre-existing exfoliation syndrome, which caused zonular weakness and subsequent anterior movement of the lens-iris diaphragm. After the patient’s third recurrence of microhyphema and inflammation, the patient underwent removal of iStent and concurrent OMNI canaloplasty for glaucoma. Six months post-iStent explantation, the patient has had complete resolution of symptoms without recurrence of hyphema. In this case report, we outline the course of this patient’s symptoms and diagnosis, discuss the potential of MIGS devices such as iStent to cause recurrent hyphema, and explore treatment options following removal.

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Complications secondary to cosmetic artificial iris anterior chamber implants: a case report

Cited by 9 publications

References 13 publications

Artificial Cosmetic Iris – Potential Risk Of Visual Impairment. A Case Report

Artificial Cosmetic Iris – Potential Risk Of Visual Impairment. A Case Report

Uveitis–Glaucoma–Hyphaema Syndrome. General review

Uveitis-Glaucoma-Hyphema Syndrome Following iStent Implantation

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