Iris Avulsion During Corneal Wound Hydration After Uneventful Cataract Extraction

We report a case of spontaneous total iris avulsion that occurred during corneal wound hydration following an uneventful phacoemulsification procedure. An 86-year-old woman underwent cataract surgery on her right eye, during which a single-piece acrylic intraocular lens (Bausch and Lomb Akreos Adapt Advanced Optics, Bausch and Lomb Incorporated, Rochester, NY, USA) was implanted in the bag, and the viscoelastic material was removed. During corneal wound hydration, total iris avulsion was observed, with the iris prolapsing out of the anterior chamber through the main wound. Wound hydration was completed, and no additional surgical intervention was performed. Four months postoperatively, the patient achieved a best corrected visual acuity of 20/50. This case highlights the importance of recognizing the pressure dynamics during corneal wound hydration and the potential risk of complications.