Anterior chamber lenses and severe segmental uveal ectropion

Seven cases of severe segmented uveal ectropion are presented. This is a color change of the iris which appears to be caused by pigment eipthelium being pulled from the pupillary margin to the footplates under a Tennant or Mark VIII anterior chamber lens. It was found in 1-2% of cases followed by the author for at least two to three years after lens implant. All eyes have poorly reactive pupils but seemingly well-fitting IOLs and good visual acuity to date. An hypothesis for its pathophysiology is presented which promotes ischemic atrophy with subsequent fibrosis of the iris as the involved mechanisms.