Bullous keratopathy and corneal decompensation secondary to iridoschisis: a clinicopathological report.
OBJECTIVE
To report a case of localized bullous keratopathy and total corneal decompensation secondary to iridocorneal touch in iridoschisis.


METHODS
Single interventional case report with pathologic correlation.


METHODS
An 80-year-old man with bilateral iridoschisis presented with loss of vision in the left eye (OS). Examination of the OS showed shallow anterior chamber (AC), cortical cataract, and free-floating iris fibers causing iridocorneal touch, leading to localized bullous keratopathy and total corneal decompensation. Ultrasound biomicroscopy (UBM) confirmed the area of iridocorneal contact.


RESULTS
Penetrating keratoplasty combined with cataract extraction and posterior chamber lens implantation was performed in the OS. Histopathology of the corneal button showed features of corneal edema and endothelial cell loss with evidence of iridocorneal contact.


CONCLUSIONS
Iridoschisis is an uncommon cause of bullous keratopathy and corneal decompensation. Patients with iridoschisis may need specular microscopy to determine the status of the corneal endothelium.
Srinivasan
Sathish
S
St Paul's Eye Unit, Royal Liverpool and Broadgreen University Hospitals, NHS Trust, Liverpool, United Kingdom. sathish@tiscali.co.uk
Batterbury
Mark
M
Hiscott
Paul
P
D000369:Aged, 80 and over; D000867:Anterior Chamber / Q000473:pathology; D002386:Cataract / Q000209:etiology; D002387:Cataract Extraction; D003315:Cornea / Q000473:pathology*; D003316:Corneal Diseases / Q000000981:diagnostic imaging / Q000209:etiology* / Q000473:pathology / Q000601:surgery; D006801:Humans; D007498:Iris / Q000473:pathology*; D007499:Iris Diseases / Q000150:complications* / Q000000981:diagnostic imaging / Q000473:pathology / Q000601:surgery; D015948:Keratoplasty, Penetrating; D019654:Lens Implantation, Intraocular; D008297:Male; D033401:Microscopy, Acoustic; D000267:Tissue Adhesions / Q000000981:diagnostic imaging / Q000209:etiology