title: Bilateral irreversible severe vision loss from cosmetic iris implants.
abstract: OBJECTIVE
  To report a case of bilateral neovascular glaucoma with central retinal vein occlusions secondary to cosmetic iris implantation.
  
  
  METHODS
  Interventional case report.
  
  
  METHODS
  setting: Tertiary care center; ophthalmology clinic. patient: A 25-year-old woman presented with persistent bilateral blurry vision after simultaneous bilateral cosmetic iris implantation. Examination showed best-corrected visual acuity of hand motion in the right and 20/400 in the left eye with intraocular pressures (IOP) of 48 mm Hg in the right and 40 mm Hg in the left eye on maximal medical therapy. She had bilateral neovascularization of the iris and angle with synechial angle closure, surgical aniridia, central retinal vein occlusion, and end-stage glaucomatous optic neuropathy. She was diagnosed with neovascular glaucoma in both eyes, associated with cosmetic iris implants. intervention procedures: Humphrey 24-2 visual field testing, optic nerve coherence tomography, and fundus imaging were performed. After bilateral intravitreal bevacizumab and panretinal photocoagulation, Ahmed glaucoma drainage devices were implanted in both eyes. main outcome measures: IOP, anterior chamber inflammation, neovascularization.
  
  
  RESULTS
  Despite aggressive treatment, severe permanent bilateral vision loss ensued.
  
  
  CONCLUSIONS
  We strongly advise against the use of anterior chamber iris implants for cosmetic indications. Close monitoring of implanted individuals is necessary. Explantation should be considered at the earliest sign of adverse reaction.
authors.affiliation: Department of Ophthalmology and Visual Science, Yale University School of Medicine, 40 Temple St, Suite 3D, Rm 375, New Haven, CT 06510-2715, USA.
authors.forename: Mathew K
authors.initials: MK
authors.lastname: George
authors.forename: James C
authors.initials: JC
authors.lastname: Tsai
authors.forename: Nils A
authors.initials: NA
authors.lastname: Loewen
mesh_terms: D000328:Adult; D000911:Antibodies, Monoclonal / Q000008:administration & dosage; D061067:Antibodies, Monoclonal, Humanized; D000068258:Bevacizumab; D001766:Blindness / Q000209:etiology* / Q000503:physiopathology / Q000601:surgery; D020878:Device Removal; D005127:Eye Color; D005260:Female; D007839:Functional Laterality; D020327:Glaucoma Drainage Implants; D015355:Glaucoma, Neovascular / Q000209:etiology* / Q000503:physiopathology / Q000601:surgery; D006801:Humans; D007429:Intraocular Pressure / Q000502:physiology; D007498:Iris; D017075:Laser Coagulation; D009901:Optic Nerve Diseases / Q000209:etiology / Q000503:physiopathology / Q000601:surgery; D019736:Prostheses and Implants / Q000009:adverse effects*; D012170:Retinal Vein Occlusion / Q000209:etiology* / Q000503:physiopathology / Q000601:surgery; D012826:Silicone Elastomers; D013518:Surgery, Plastic / Q000009:adverse effects*; D014792:Visual Acuity / Q000502:physiology; D014794:Visual Fields / Q000502:physiology
chemical_list: D000911:Antibodies, Monoclonal; D061067:Antibodies, Monoclonal, Humanized; D012826:Silicone Elastomers; D000068258:Bevacizumab