Introduction: Various complications have been reported to occur after cosmetic artificial iris implant surgery performed on healthy eyes. We describe a case of secondary glaucoma that developed in a patient who had undergone cosmetic artificial iris implant surgery overseas.
Case: The patient, a 32-year-old woman, visited eye clinic because she noticed blurry vision in her right eye. She was found to have elevated intraocular pressure (IOP) and referred to our hospital. Her past medical history included artificial iris implant surgery that she had undergone four years ago in Jordan. At the initial examination, her best-corrected visual acuity was 1.2 in both eyes. IOP was 34 mmHg in the right eye and 28 mmHg in the left eye. General ophthalmic examinations indicated a BrightOcular artificial iris and slight cupping of the optic disc in both eyes. Gonioscopy revealed peripheral anterior synechia and pigmentation in both eyes. The corneal endothelial cell count had decreased to 1905±204 cells/mm2 in the right eye and 1901±200 cells/mm2 in the left eye. Goldmann perimetry showed mild depression of the internal isopters. IOP in the right eye remained high despite the administration of IOP-lowering medication, and we recommended artificial iris extraction and glaucoma surgery. However, as the patient refused to undergo artificial iris extraction, trabeculectomy alone was performed in the right eye. Although the left eye was also considered to be indicated for surgery due to elevated IOP, decreased visual acuity, enlargement of optic disc cupping, and progression of visual field loss, trabeculectomy alone was performed as is the case in the right eye.
Conclusions: An increasing number of young Japanese individuals may undergo cosmetic artificial iris implant surgery in the future due to the spread of information on social media. Since in cases of secondary glaucoma following cosmetic iris implant surgery, performing trabeculectomy alone is not enough, artificial iris extraction also needs to be performed.
Nippon Ganka Gakkai Zasshi (J Jpn Ophthalmol Soc) 124: 644-654, 2020.