Severe visual commitment, secondary glaucoma and bullous keratopathy after bilateral cosmetic iridian implant

Session Details

Session Title: Endophthalmitis/ Ocular Infections/ Miscellaneous

Session Date/Time: Tuesday 10/10/2017 | 08:00-10:30

Paper Time: 08:56

Venue: Room 4.6

First Author: : I.Ramirez Jimenez PERU

Co Author(s): :    J. Izquierdo Villavicencio   M. Ponte-Davila   F. Quezada Baltodano   A. González Méndez           

Abstract Details

Purpose:

To describe the clinical, treatment, surgical management and complications at 6 years in phakic patient with bilateral iridian cosmetic implant with evolution to severe visual compromise.

Setting:

Research Department, Oftalmosalud Eye Institute, Lima-Peru, Av. Javier Prado Este 1142, San Isidro, Lima, Peru

Methods:

A 33-year-old male, comes to Oftalmosalud in July 2013, with decreased Visual Acuity and ocular pain with history of cosmetic iris implantation (NewcolorIris) OU 6 years ago. VA: CF OU, IOP: 66mmHg OD , 37mmHg OS using maximal therapy. Biomicroscopy: Severe corneal edema OD and moderate OS, iridian implant in anterior chamber, cataract, anterior and posterior synechia in OU. Gonioscopy;OD not evaluable OS: 0. Specular microscopy OD not evaluable; OS: 365 c / mm Iridian implant removal + trabeculectomy with ologen + express OU was performed. IOP post: 12 mmHg OD and 13mmHg OS. Cornea under decompensation even with normal IOP, endothelial keratoplasty, phacoemulsification and iridoplasty were performed in OS, maintaining pressures of 10 mmHg. Later in OD IOP of 47mmHg, a Baerveldt + phacoemulsification implant was performed, presenting choroidal detachment, atalamia and endothelial touch of the tube, being resolved with oral and topical prednisone every 3 hours. It reached 9 mmHg IOP in OD. Corneal transplantation was indicated for OD due to bullous keratopathy.but the patient didn’t return

Results:

Follow up 1 year: VA: HM in OD, CD in OS; IOP: 9 mmHg in OU with maximal therapy.

Conclusions:

Iridian cosmetic implants can lead to severe complications even after their removal, such as difficult-to-manage secondary glaucoma, corneal failure, cataract, uveitis, and irreversible visual loss.

Financial Disclosure:

NONE