[Iris prosthesis in traumatic aniridia as an attempt to control refractory glaucoma induced by silicone oil in the anterior chamber: case report].
The objective of this report is to demonstrate the effectiveness of an iris prosthesis to treat a refractory glaucoma induced by silicone oil in the anterior chamber. This case is about a patient who suffered a trauma caused by firearm shrapnel. A vitreous-retinal surgery was performed to remove intraocular foreign matter and to realign the retina that was detached. Due to the partial traumatic aniridia, silicone oil that was introduced in the vitreous chamber to keep the retina in place migrated to the anterior chamber, resulting in the decrease of endothelium cells and uncontrollable intraocular pressure. We performed transscleral fixation of the iris prosthesis to correct these problems. After a 45-month period of evolution, sight became stable at the 1 meter finger-count distance and intra-ocular pressure at 14 mmHg We may conclude that the triad that consists of lack of: iris diaphragm, aphakia and silicone oil that could not be removed because of inexorable occurrence of detachment of the retina should lead the surgeon to consider transscleral fixation of the iris prosthesis. This procedure might control intraocular pressure and/or preserve corneal transparency, preventing silicone oil from contact with the trabecular net and the corneal endothelium.
Torres
Rogil José de Almeida
RJ
Instituto da Visão, Universidade Federal de São Paulo, São Paulo, Brazil. rjat@terra.com.br
Luchini
Andréa
A
Torres
Rogério João de Almeida
RJ
Abib
Fernando César
FC
Torres
Reginaldo Antônio de Almeida
RA
D000328:Adult; D015783:Aniridia / Q000209:etiology* / Q000601:surgery; D000867:Anterior Chamber; D005129:Eye Foreign Bodies / Q000150:complications*; D005901:Glaucoma / Q000139:chemically induced; D006801:Humans; D007498:Iris / Q000601:surgery*; D008297:Male; D019736:Prostheses and Implants; D012827:Silicone Oils / Q000009:adverse effects; D016896:Treatment Outcome; D014948:Wounds, Gunshot / Q000150:complications
D012827:Silicone Oils