Post-traumatic iridodialysis, crystalline dislocation and vitreous haemorrhage: how to manage

Loiudice, Pasquale; Casini, Giovanni

doi:10.1136/bcr-2014-205595

Cited by 2 publications

(3 citation statements)

References 13 publications

(10 reference statements)

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“…Traumatic iritis and iris sphincter rupture frequently develop after a closed-globe injury. Although closed-globe injury is also primarily responsible for iridodialysis and iris defects, it may also be associated with penetrating injuries [ 5 , 6 ].…”

Section: Discussionmentioning

confidence: 99%

“…In some instances of corneal or corneoscleral laceration, the iris can undergo root avulsion from the ciliary body, leading to iridodialysis, aniridia, and dark brown iris tissue incarcerated in the wound. Expulsive iridodialysis or traumatic aniridia often accompany other injuries, such as lens dislocation, cataract, commotio retinae, and retinal detachment [ 3 , 6 ]. The expulsed iris may or may not be identified during surgery, as blood in the anterior chamber often prevents adequate visualization of the anterior segment.…”

Section: Discussionmentioning

confidence: 99%

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Traumatic dislocation of the iris into the vitreous cavity with intact lens: a case report

Xie,

Chen,

Wang

et al. 2023

BMC Ophthalmol

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Background Traumatic aniridia occurs when the iris is extruded from the eye and is often accompanied by lens injuries. However, traumatic aniridia due to dislocation of the iris into the vitreous cavity without lens damage has never been reported. Case presentation A 30-year-old man presented with visual loss and pain for 6 h after a thin wire injured his right eyeball. Ophthalmologic examinations manifested a 2 mm full-thickness corneal laceration and total hyphema. An intact clear lens, healthy attached retina, and almost complete iris tissue in the vitreous cavity were found after resolution of hyphema the next day. Further examination revealed that the defect in the zonule below the corneal wound was the path for the iris to enter the vitreous cavity. The patient opted for nonsurgical treatment until pigment granules and opacity were observed in the vitreous cavity after 50 days. Vitrectomy was performed to remove the dislocated iris. Conclusions The presentation of this unique case indicates that the torn iris was displaced to the vitreous cavity with an intact lens and missing local zonula instead of out the corneal laceration after a penetrating injury. The type of injury, mechanism, and force on the spot may contribute to the occurrence of this rare condition. Instead of artificial irises, tinted glasses were more appropriate treatment option for this patient. Peripheral retinal examination was essential in the management of this case. In such cases, the iris in the vitreous cavity should be resected to prevent complications.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Traumatic dislocation of the iris into the vitreous cavity with intact lens: a case report

Xie,

Chen,

Wang

et al. 2023

BMC Ophthalmol

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“…It usually follows severe contusion injury of the eyeball. In a surgically naïve eye, this phenomenon often accompanies other injuries such as scleral rupture, lens dislocation, or commotio retinae [6,7].…”

Section: Discussionmentioning

confidence: 99%

Traumatic aniridia with extensive episcleral pigmentation: a case report

Yang

Liu

2022

BMC Ophthalmol

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Background Traumatic aniridia has been documented in eyes with a history of cataract extraction through a clear corneal wound. The proposed hypothesis is that the iris tissue was squeezed out from the corneal wound as it is a relative weak point. However, traumatic aniridia with extensive pigmentation of the episclera has never been reported. Case presentation A patient, who has surgical histories of trabeculectomy and cataract surgery many years ago, presented with refractory high intraocular pressure (IOP), almost complete loss of the iris, and diffuse pigmentation of the episclera after he had suffered from a contusion injury. In addition to numerous pigment particles and cells in the anterior chamber and a well-centered intraocular lens, protruding uvea tissue with overlying conjunctiva adjacent to the site of trabeculectomy was noted. Gonioscopy showed absence of the iris with clear view of the ciliary body. Conclusions The distinct presentation of this case indicates that the torn iris was displaced to the trapdoor instead of the clear cornea incision and was confined to the subconjunctival space. The scleral fistula serves as a less resistant point for releasing pressure compared to a healed corneal wound when the eye encounters a contusion injury. Further treatment options to lower IOP include repeated trabeculectomy, implantation of glaucoma drainage device, and endoscopic cyclophotocoagulation. Transscleral cyclophotocoagulation may be considered only after episcleral pigmentation has become less so as to avoid the risk of surface burn.

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Post-traumatic iridodialysis, crystalline dislocation and vitreous haemorrhage: how to manage

Cited by 2 publications

References 13 publications

Traumatic dislocation of the iris into the vitreous cavity with intact lens: a case report

Traumatic dislocation of the iris into the vitreous cavity with intact lens: a case report

Traumatic aniridia with extensive episcleral pigmentation: a case report

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