Komplikationen nach kosmetischer Irisimplantation

Abstract

We report the case of a 37-year-old patient with ocular complications associated with the implantation of cosmetic iris implants. Implantation of silicone iris implants for the purpose of changing iris colour has been performed since 2004. Diaphragms are implanted in the anterior chamber. Up to now only little information exists about side effects of this method. In the literature severe ocular complications shortly after cosmetic iris implantation are reported in single cases. In our case 5 months after surgery optic nerve damage caused by elevated intraocular pressure (IOP) was diagnosed. Nuclear opacity of both lenses and a decreased number of corneal endothelial cells were observed at the first visit. Because of recurrent IOP elevation despite maximum antiglaucoma therapy, explantation of the iris implants was required. Damage to the trabecular meshwork, opacity of the lenses as well as the reduced number of endothelial cells are permanent and will probably lead to further complications like corneal decompensation and progressing glaucoma.

Long-term results after artificial iris implantation in patients with aniridia

“…According to our experience, a diameter of 11 mm after trephination is suitable for most eyes. This might be the reason why we did not see a significant increase of IOP after artificial iris implantation compared to previous studies [6]. Mayer et al also recommend a smaller diameter and achieved a low complication rate with glaucoma [16].…”

“…A severe complication after artificial iris implantation is glaucoma [6]. In this study, 9 % developed glaucoma after implantation.…”

“…It has a diameter of 12.8 mm and a decreasing thickness from pupil margin (0.4 mm) towards periphery (0.25 mm). It can be easily cut with scissors or with a trephine and then inserted through small incisions into the ciliary sulcus of pseudophakic or aphakic eyes [6]. The iris prosthesis is custom-made to match the color of the patient's natural iris.…”

Serious ocular complications of cosmetic iris implants in 14 eyes

“…[5][6][7][8][9][10] Clinical examination in our series of 14 eyes confirmed multiple complications from these implants, including increased IOP, pigment dispersion, uveitis, corneal edema, a depressed ECC, UGH syndrome, glaucomatous optic neuropathy, CME, and suprachoroidal hemorrhage.…”

“…These complications include severe vision loss, uveitis-glaucoma-hyphema (UGH) syndrome, elevated intraocular pressure (IOP), endothelial cell loss, bullous keratopathy, and end-stage glaucomatous optic neuropathy. [5][6][7][8][9][10] However, information on the long-term management and visual outcomes of these patients is lacking. George et al 8 reported through a personal communication with Kahn Medical in 2001 that more than 700 procedures had been performed since 2002, with an incidence of chronic inflammation of 1.5% and an occurrence of raised IOP that could be adequately controlled with eyedrops.…”