Uveitis-Glaucoma-Hyphema Syndrome and Corneal Decompensation in Association With Cosmetic Iris Implants

Stella N. Arthur, Martha M. Wright, Natalia Kramarevsky, Stephen C. Kaufman, Alana L. Grajewski

Research output: Contribution to journalArticle

30 Scopus citations

Abstract

Purpose: To report a case and management of uveitis-glaucoma-hyphema (UGH) syndrome and corneal decompensation associated with cosmetic iris implants. Design: Interventional case report. Methods: settings: Department of Ophthalmology, University of Minnesota School of Medicine. patients: 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. intervention: 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. main outcome measures: 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. Conclusion: 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.

Original languageEnglish (US)
Pages (from-to)790-793
Number of pages4
JournalAmerican journal of ophthalmology
Volume148
Issue number5
DOIs
StatePublished - Nov 1 2009

ASJC Scopus subject areas

  • Ophthalmology

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