Complications Of Cosmetic Artificial Iris Implantation And Post Explantation Outcomes

American Journal of Ophthalmology
27 Jan, 2021 ,

Reza Ghaffari et al. conducted a retrospective case series analysis aimed at reporting complications associated with cosmetic artificial iris implantation and explantation outcomes. The medical records of 12 patients who underwent implantation of cosmetic artificial irises were evaluated for presenting symptoms, examination findings, and management outcomes. The subjects presented with varying symptoms such as iris abnormalities, elevated intraocular pressure, corneal edema, intraocular inflammation, and cataract. It was seen that even after surgical intervention serious long term complications (which included among others native iris defects, persistent glaucoma and cataract) persisted.

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Abstract

Purpose

: To report complications of cosmetic artificial iris implantation and explantation outcomes.

Setting

: Stein Eye Institute

Design

: Retrospective case series

Methods

: Review of medical records of 12 patients (24 eyes) who presented to us after being implanted with cosmetic artificial irises elsewhere. Data collected included baseline demographics, presenting symptoms, examination findings, and management outcomes.

Results

: Eight eyes had NewColorIris implants and 16 had BrightOcular implants. Mean interval from cosmetic iris implantation to presentation was 61.7 ± 60.0 months. The mean follow up after explantation was 35.5 ± 38.1 months. Complications at presentation included iris abnormalities (11 eyes, 45.8%), elevated intraocular pressure (8 eyes, 33.3%), corneal edema (6 eyes, 25%), intraocular inflammation (5 eyes, 20.8%), and cataract (4 eyes, 16.7%). Surgical interventions included cosmetic iris removal (19 eyes, 79.2%), cataract extraction (7 eyes, 29.2%), corneal transplantation (7 eyes, 29.2%), and glaucoma surgery (4 eyes, 16.7%). Complications at the last follow up examination included native iris defects (11 eyes 45.8%), persistent glaucoma (7 eyes, 29.2%), cataract (5 eyes, 20.8%), corneal edema (4 eyes, 16.7%), and intraocular inflammation (2 eyes, 8.3%). The mean logarithm of the minimum angle of resolution (LogMAR) was 0.56 ± 0.47 at presentation and 0.78 ± 0.88 at the last examination (p = 0.30). Mean intraocular pressure was 22.7 ± 15.8 mmHg at presentation and 13.4 ± 6.99 mmHg at the last examination (p = 0.02).

Conclusion

: Cosmetic iris implantation was associated with serious complications at the time of presentation and adverse sequelae persisted for years following explantation.