A case of cataract surgery without pupillary device in the eye with iridoschisis.
OBJECTIVE
To introduce a case of iridoschisis patient who underwent cataract surgery successfully without pupil device.


METHODS
A 64-year-old female who showed iridoschisis of her both eyes underwent cataract operation at her right eye without a pupillary device. The preoperative and postoperative ophthalmologic examinations including visual acuity, intraocular pressure, reaction of anterior chamber, and degree of damage on iris was evaluated respectively.


RESULTS
Cataract surgery was performed under topical anesthesia through a clear corneal incision. Iris fibrils were held in place by ophthalmic viscosurgical device (OVD, sodium hyaluronate 3%-sodium chondroitin sulfate 4%, Viscoat) that was injected into the anterior chamber. A small capsulorrhexis was made and the nucleus was delivered with low-power phacoemulsification, most of which was performed under the anterior capsule. The iris came into contact with the OVDs only and received no mechanical trauma. There were no intraoperative complications such as tear of the iris, hyphema, loss of mydriasis, or rupture of the posterior lens capsule. The edema of corneal stroma and inflammation of anterior chamber was shown at immediate-postoperative period, but completely subsided 2 weeks later. The visual acuity showed improvement from 20/400 to 20/30.


CONCLUSIONS
In iridoschisis patients, there is a risk of aspiration of iris fibers during cataract surgery. With adequate use of OVD and careful modulation of surgical devices, cataract surgery was successfully performed without using extra pupil-supporting device.
Lee
Eun Ji
EJ
Department of Ophthalmology, Seoul National University College of Medicine, Seoul, Korea.
Lee
Jin Hak
JH
Hyon
Joon Young
JY
Kim
Mee Kum
MK
Wee
Won Ryang
WR
D000772:Anesthesia, Local / Q000379:methods; D002386:Cataract / Q000150:complications*; D002807:Chondroitin / Q000008:administration & dosage; D002809:Chondroitin Sulfates; D004338:Drug Combinations; D005260:Female; D006801:Humans; D006820:Hyaluronic Acid / Q000008:administration & dosage; D007499:Iris Diseases / Q000150:complications*; D019654:Lens Implantation, Intraocular; D008875:Middle Aged; D018918:Phacoemulsification / Q000379:methods*; D014792:Visual Acuity
D004338:Drug Combinations; C501944:chondroitin sulfate, sodium hyaluronate drug combination; D006820:Hyaluronic Acid; D002807:Chondroitin; D002809:Chondroitin Sulfates