Uveitis-glaucoma-hyphema syndrome and corneal decompensation in association with cosmetic iris implants.
OBJECTIVE
To report a case and management of uveitis-glaucoma-hyphema (UGH) syndrome and corneal decompensation associated with cosmetic iris implants.


METHODS
Interventional case report.


METHODS



METHODS
Department of Ophthalmology, University of Minnesota School of Medicine.


METHODS
A 29-year-old man presented with bilateral redness, severe pain, photophobia, and reduction in visual acuity. Examination revealed intraocular pressure (IOP) of 38 mm Hg and 40 mm Hg right and left eye respectively, bilateral conjunctival injection 3+, epithelial corneal edema, microhyphema, cells 3+ to 4+ and flare 2+, bilateral cosmetic iris implants, and surgical peripheral iridectomies. The patient was diagnosed with UGH syndrome and corneal decompensation associated with cosmetic iris implants.


METHODS
Immediate medical management of inflammation and elevated IOP, anterior segment imaging, specular microscopy, Humphrey 24-2 visual field (VF) testing; following failed conservative management, combined trabeculectomy and removal of the iris implants.


METHODS
Anterior chamber inflammation and microhyphema, IOP, and corneal edema.


RESULTS
Anterior segment imaging demonstrated bilateral implant-iris apposition and implant-angle structures apposition. Specular microscopy demonstrated a significant reduction of the number of endothelial cells. VF test demonstrated a right superior arcuate scotoma and a normal left VF. Following surgical treatment IOP normalized and inflammation and microhyphema subsided. However, mild corneal edema persisted.


CONCLUSIONS
Cosmetic iris implantation may lead to UGH syndrome and corneal decompensation. Therefore, its use should be reserved for patients with significant medical indications, and avoided in patients with intact natural iridies, until more short-term and long-term safety data are available.
Arthur
Stella N
SN
Department of Ophthalmology, University of Minnesota, Minneapolis, MN 55455, USA.
Wright
Martha M
MM
Kramarevsky
Natalia
N
Kaufman
Stephen C
SC
Grajewski
Alana L
AL
D000328:Adult; D015715:Corneal Edema / Q000175:diagnosis / Q000209:etiology* / Q000601:surgery; D020878:Device Removal; D005901:Glaucoma / Q000175:diagnosis / Q000209:etiology* / Q000601:surgery; D006801:Humans; D006988:Hyphema / Q000175:diagnosis / Q000209:etiology* / Q000601:surgery; D007429:Intraocular Pressure; D007498:Iris; D008297:Male; D019736:Prostheses and Implants / Q000009:adverse effects*; D019919:Prosthesis Implantation; D012086:Reoperation; D013577:Syndrome; D014130:Trabeculectomy; D014606:Uveitis, Anterior / Q000175:diagnosis / Q000209:etiology* / Q000601:surgery; D014792:Visual Acuity