Case Reports

Post operative pigment dispersion syndrome: a rare cause of presumed imprint iris atrophy due to partially opened IOL haptic loop

Case Report Details

First Author: L.Daniel Ponniah INDIA

Co Author(s):                        

Abstract Details

Purpose:

To demonstrate a unique postoperative cataract surgery complication of iatrogenic florid pigment dispersion and glaucoma, following an uneventful cataract procedure and the way how it was managed.

Setting:

A case report from the Department of Cataract and Refractive Surgery, in a tertiary eye care center, South India

Report of Case:

A 56 YO/F underwent an uneventful cataract procedure with IOL implantation in the bag with a 20/20 vision postoperatively. On 18th POD she developed a severe iris pigment dispersion with glaucoma in which attempted medical management could not restrict pigment dispersion. All possible reasons including viral etiology, drug toxicity were all ruled out. On 30th POD. The incision was reopened and a thorough power wash of pigments on the IOL surface failed & hence IOL was exchanged along with an intravitreal injection of triamcinolone acetonide to prevent cystoid macular edema. Vision recovered well, with a quiet eye. On slit-lamp observation, a unique pattern of inferior mid-peripheral iris atrophy was noted which resembled the haptic loop of a single piece IOL (imprint iris atrophy of IOL haptic loop) presumably the pathogenesis being anteriorly displaced partially unfolded IOL haptic- bag complex rubbing the pigmented iris being the reason behind the storm of pigment release

Conclusion/Take Home Message:

Anterior displacement of IOL bag complex, with partial unfolded haptic, could result in severe iatrogenic iris pigment dispersion syndrome and IOL exchange appears to be a good cause-oriented approach.

Financial Disclosure:

None