Iris reconstruction with a multipiece endocapsular prosthesis in iridocorneal endothelial syndrome

Iris reconstruction in cases of iridocorneal endothelial (ICE) syndrome is extremely challenging because of the nature of the iris tissue, which is typically friable and poorly suited to suture repair. Reconstruction in such cases often requires artificial iris implantation. This report illustrates cataract extraction and iris reconstruction with a multipiece endocapsular iris prosthesis that can be inserted through a small incision. Maintenance of a small incision size is a distinct advantage when glaucoma is coexistent in patients with ICE syndrome. It also demonstrates the presence of an ICE membrane over the anterior capsule and the importance of recognizing this membrane rather than confusing it with the anterior capsule when performing the capsulorhexis.