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Massive pseudophakic pigment dispersion associated with an iris nevus
1Department of Ophthalmology, Beilinson Medical Center, Petah Tiqva, Israel.
Ophthalmic Surgery
|March 1, 1989
Summary
A patient developed pigment dispersion, corneal edema, and glaucoma after cataract surgery. Histopathology revealed iris erosion by the intraocular lens (IOL) loop, not phakoanaphylactic uveitis.
Area of Science:
- Ophthalmology
- Ophthalmic Pathology
Background:
- Cataract surgery with posterior chamber intraocular lens (IOL) implantation can lead to complications.
- Pigment dispersion syndrome is a known, though uncommon, complication associated with certain IOL designs.
Observation:
- A 67-year-old woman presented with significant ocular complications 12 months post-extracapsular cataract extraction.
- These complications included pseudophakic pigment dispersion, corneal epithelial edema, uveitis, and secondary glaucoma.
Findings:
- Histopathological examination of the explanted IOL and iris tissue revealed iris erosion by the IOL loop.
- A pigmented iris nevus was identified, but no evidence of phakoanaphylactic uveitis was found, despite the severe inflammation.
- The patient later developed streptococcal endophthalmitis, necessitating evisceration.
Implications:
- This case highlights the potential for mechanical iris damage from IOL loops, leading to pigment dispersion and secondary glaucoma.
- It underscores the importance of careful IOL selection and monitoring for delayed complications.
- The absence of phakoanaphylactic uveitis in this context suggests alternative inflammatory pathways may be involved in severe pseudophakic eyes.