Abstract
Purpose: To report a case and management of uveitis-glaucoma-hyphema (UGH) syndrome and corneal decompensation associated with cosmetic iris implants. Design: Interventional case report. Methods: settings: Department of Ophthalmology, University of Minnesota School of Medicine. patients: A 29-year-old man presented with bilateral redness, severe pain, photophobia, and reduction in visual acuity. Examination revealed intraocular pressure (IOP) of 38 mm Hg and 40 mm Hg right and left eye respectively, bilateral conjunctival injection 3+, epithelial corneal edema, microhyphema, cells 3+ to 4+ and flare 2+, bilateral cosmetic iris implants, and surgical peripheral iridectomies. The patient was diagnosed with UGH syndrome and corneal decompensation associated with cosmetic iris implants. intervention: Immediate medical management of inflammation and elevated IOP, anterior segment imaging, specular microscopy, Humphrey 24-2 visual field (VF) testing; following failed conservative management, combined trabeculectomy and removal of the iris implants. main outcome measures: Anterior chamber inflammation and microhyphema, IOP, and corneal edema. Results: Anterior segment imaging demonstrated bilateral implant-iris apposition and implant-angle structures apposition. Specular microscopy demonstrated a significant reduction of the number of endothelial cells. VF test demonstrated a right superior arcuate scotoma and a normal left VF. Following surgical treatment IOP normalized and inflammation and microhyphema subsided. However, mild corneal edema persisted. Conclusion: Cosmetic iris implantation may lead to UGH syndrome and corneal decompensation. Therefore, its use should be reserved for patients with significant medical indications, and avoided in patients with intact natural iridies, until more short-term and long-term safety data are available.
| Original language | English (US) |
|---|---|
| Pages (from-to) | 790-793 |
| Number of pages | 4 |
| Journal | American journal of ophthalmology |
| Volume | 148 |
| Issue number | 5 |
| DOIs | |
| State | Published - Nov 2009 |
Bibliographical note
Funding Information:This study was supported by an unrestricted grant from Research to Prevent Blindness Inc, New York, New York. Dr Wright serves on the advisory board for Allergan Inc and is associated with Watermark Research Partners. Involved in design and conduct of study (S.N.A., M.M.W., A.L.G.); collection, management, analysis, and interpretation of data (S.N.A., M.M.W., N.K., S.C.K., A.L.G.); and preparation, review, or approval of the manuscript (S.N.A., M.M.W., N.K., S.C.K., A.L.G.). The University of Minnesota Institutional Review Board waived the need for approval.
Copyright:
Copyright 2009 Elsevier B.V., All rights reserved.