Endoresection of the iris and ciliary body in epithelial downgrowth

We present a case of epithelial downgrowth with intractable glaucoma after multiple intraocular surgeries. The eye was successfully managed with a pars plana approach. The iris and epithelial tissue over the ciliary body were removed with intraocular scissors and a vitrector combined with unipolar diathermy and endophotocoagulation. The use of moderate hypotensive anesthesia may have helped prevent intraoperative hemorrhage. During more than 3 years of follow-up, intraocular pressure ranged from 13 to 19 mm Hg, visual acuity was 20/80 with aphakic correction with a rigid gas-permeable lens, and there was no recurrence of epithelial downgrowth.