1/53. "The disappearing lens": failure of CT to image the lens in traumatic intumescent cataract.The CT scans of three patients whose eyes were lacerated by trauma failed to demonstrate the lens. A slit-lamp examination of those eyes clearly indicated that the lenses were present behind the iris but that they were swollen and opaque (intumescent cataract). Apparently, a shift of water into the injured lens had reduced the expected hyperdense CT image of the lens to a level that it was no longer discernible.- - - - - - - - - - ranking = 1keywords = iris (Clic here for more details about this article) |
2/53. Severe iridodialysis from phacoemulsification tip suction.During cataract surgery, the iris of an 83-year-old woman was strongly sucked into the phacoemulsification tip twice, resulting in severe iridodialysis. The dehisced iris was sutured to the sclera using double-armed 10-0 polypropylene on a long curved needle. Intensive suction of the iris by the phacoemulsification tip can lead to severe iridodialysis. Machine setting parameters, particularly flow rate, should be lowered after the first iris suction to avoid further iris damage.- - - - - - - - - - ranking = 5keywords = iris (Clic here for more details about this article) |
3/53. Transpupillary argon laser cyclophotocoagulation in the treatment of traumatic glaucoma.PURPOSE: A patient with traumatic glaucoma who underwent transpupillary argon laser cyclophotocoagulation for management of uncontrolled intraocular pressure (IOP) despite maximally tolerated medical therapy is discussed. methods: In this patient, pars plana vitrectomy, lensectomy, and removal of 180 degrees of necrotic iris had been performed after a blunt trauma with a bungee cord. Six weeks after surgery, the patient presented with an IOP of 40 mmHg despite therapy with three aqueous suppressants. The patient refused further surgical intervention and opted for transpupillary argon laser cyclophotocoagulation (talc). The laser setting was 1,000 mW, with a 50-micron spot size for 0.1 second. A total of 293 laser exposures through a Goldmann contact lens was administered to all visible ciliary processes over 180 degrees where iris structures were absent. RESULTS: Ten weeks after talc, the patient's IOP remained controlled with medications at 16 mmHg, and visual acuity had improved to 20/25 with an aphakic contact lens. CONCLUSION: In selected patients whose ciliary processes are visible with indirect gonioscopy due to the defect in the iris, talc may be an effective alternative cyclodestructive procedure to lower IOP when conventional medical or laser treatments are not successful.- - - - - - - - - - ranking = 3keywords = iris (Clic here for more details about this article) |
4/53. Triangular transchamber suture.A 64-year-old woman with a fibrous membrane at the lens plane after traumatic loss of all the iris and massive intraocular hemorrhage had posterior chamber intraocular lens (PCIOL) implantation anterior to the fibrous membrane with a triangular transchamber suture to prevent possible PCIOL-corneal touch and enhance the stability of the PCIOL. After 3 years, the PCIOL remained in a good position and visual rehabilitation was satisfactory and without complications.- - - - - - - - - - ranking = 1keywords = iris (Clic here for more details about this article) |
5/53. Ocular morbidity associated with airbag deployment: a report of seven cases and a review of the literature.PURPOSE: To review ocular injuries secondary to airbag deployment that were seen in our institution and were reported in the literature. methods: patients examined at our institution between 1997 and 2000 were evaluated for ocular injuries caused by airbags. A review of the medical literature using medline was performed. All reports involving ocular injuries secondary to airbags were included in this study. RESULTS: Seven cases from our medical center were identified to involve airbag-related eye injuries. The ages of the patients ranged from 4 to 73 years. Ocular injuries included corneal abrasion, corneal decompensation, corneal alkali injury, hyphema, iris sphincter tears, vitreous hemorrhage, macular retinal pigment epithelium disruption, dislocated posterior chamber intraocular lens, and commotio retinae. A review of the medical literature showed 74 cases involving 80 eyes. The ages of the patients ranged from 2 to 81 years. Males slightly outnumbered females by a ratio of 1.1 to 1.0. The speed of the vehicles ranged from 0 to 65 miles per hour, with an average reported speed of 31 miles per hour. Reported injuries ranged from mild corneal abrasions to open globes. CONCLUSIONS: Ocular morbidity secondary to airbag deployment must be recognized as a significant risk for motor vehicle drivers and passengers. Improvements in airbag safety will include increased consumer awareness and manufacturer design modification.- - - - - - - - - - ranking = 1keywords = iris (Clic here for more details about this article) |
6/53. iris alteration using mechanical iris retractors.A 74-year-old woman had a 3-port pars plana vitrectomy for a dropped nucleus after complicated phacoemulsification. Flexible nylon iris retractors were positioned to dilate the small pupil. The patient died of a pulmonary embolus 1 day after surgery. The eyeball was removed at autopsy, and pathology of the iris was investigated. Localized damage to the iris where the retractor hooks were positioned was noted, but no other alterations to the iris were observed. These findings may explain the recovery of pupil function that is common after surgery with mechanical iris retractors.- - - - - - - - - - ranking = 9keywords = iris (Clic here for more details about this article) |
7/53. Mystery of the vanishing iris.We present the first reported case of traumatic aniridia as an isolated injury after blunt trauma to an eye that had phacoemulsification through a corneal tunnel. This case provides insight into the properties of the self-sealing corneal tunnel and possible advantages that it may confer on the eye.- - - - - - - - - - ranking = 4keywords = iris (Clic here for more details about this article) |
8/53. Three-dimensional ultrasound findings of the posterior iris region.PURPOSE: The aim of this study was to assess the benefit of the three-dimensional ultrasound biomicroscopy in examination of the posterior iris and ciliary body. methods: Three-dimensional visualisation of the anterior eye section was achieved through extension of the existing ultrasound biomicroscope system (Humphrey Instruments). Visualisation of posterior iris and ciliary body pathologies in three patients was performed with a three-dimensional reconstruction technique of B-scans. RESULTS: The extended ultrasound system provided three-dimensional visualisation of alterations of the posterior iris region, i.e. iris cysts, ciliary body cysts and solid tumours of the ciliary body and iris. CONCLUSIONS: The three-dimensional ultrasound biomicroscopy yields extended diagnostic findings regarding iris and ciliary body pathology. This method offers an improved assessment of the posterior surface of the iris and the volume of the ciliary body. Furthermore, these data can be useful for procedures in computer simulation and calculation for a better understanding of the function of the ciliary body in the accommodation process.- - - - - - - - - - ranking = 11keywords = iris (Clic here for more details about this article) |
9/53. Pathogenesis of transient high myopia after blunt eye trauma.OBJECTIVE: To determine the pathogenesis of transient high myopia after blunt eye trauma. DESIGN: Two observational case reports and literature review. methods: Refraction was measured in two patients with an autorefractometer in the acute and convalescent stages after a blunt eye injury. The anterior chamber angle, the ciliary body, and the choroid were examined by ultrasound biomicroscopy (UBM) in the acute and convalescent stages. In one patient, the anterior chamber depth, lens thickness, and axial length were measured by A-scan ultrasonography in the acute and convalescent stages. MAIN OUTCOME MEASURES: Comparison of the refraction, anterior chamber depth, lens thickness, axial length, and the UBM-determined appearance of the choroid and ciliary body during the acute stage with the values during the convalescent stages. RESULTS: The first patient showed a myopic shift of -9.75 diopters (D) and an anterior chamber shallowing of 0.94 mm measured 3 days after trauma by an air bag inflation compared with the measurements at the convalescent phase. UBM showed an annular ciliochoroidal effusion with ciliary body edema, anterior rotation of the ciliary processes, and disappearance of the ciliary sulcus. Eleven days after the injury, these UBM findings normalized, and the myopia decreased to -0.75 D, 27 days after trauma. The second patient had a myopic shift of -8.9 D compared with the convalescent phase, immediately after blunt trauma by a firework. Seven days after the injury, UBM revealed a partial cyclodialysis in addition to findings similar to those in the first patient. Ten days after injury, a myopic shift (-4.75 D), anterior chamber shallowing (by 1.1 mm), and thickening of the crystalline lens (by 0.27 mm) were observed compared with the convalescent phase. Associated UBM findings confirmed the anterior shift of the lens-iris diaphragm. Seventeen days after trauma, the UBM findings, including the cyclodialysis, were normalized, and the myopia had decreased to -1.0 D. CONCLUSIONS: Transient high myopia after blunt trauma is caused by anatomic changes in the ciliary body and crystalline lens. The anterior shift of the lens-iris diaphragm caused by ciliochoroidal effusion with ciliary body edema and thickening of the crystalline lens from blunt eye trauma are involved in traumatic high myopia.- - - - - - - - - - ranking = 2keywords = iris (Clic here for more details about this article) |
10/53. Traumatic dislocation of an Ophtec Artisan phakic intraocular lens.PURPOSE: To report a case of a traumatic dislocation of an Ophtec Artisan phakic anterior chamber intraocular lens. methods: Retrospective case review. RESULTS: A 38-year-old female underwent successful implantation of an Ophtec Artisan lens in her left eye as part of the phase III U.S. clinical trials. Approximately 5 months postoperatively, the patient was struck with a roll of packing tape in her left eye and noted immediate decreased vision. Following the blunt trauma, the patient had an uncorrected visual acuity (UCVA) of 20/60 and a best spectacle-corrected visual acuity (BSCVA) of 20/20. The wound was intact, however, the superior claw was no longer enclaved to the iris and the lens had dislocated nasally with the optic of the lens resting in the angle. The patient was taken back to the operating room, the lens was repositioned, and the superior claw was re-enclaved to the iris. One week after repositioning, UCVA was 20/30 and BSCVA was 20/20. CONCLUSION: Despite adequate positioning, significant trauma may result in the iris claw tearing free from the iris with dislocation of the Artisan lens. The lens may be repositioned with good visual outcome, however, the long-term effects on endothelial cell density in this patient remain to be seen.- - - - - - - - - - ranking = 4keywords = iris (Clic here for more details about this article) |
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