ESCRS - O28 - TWO-STEP PROGRESSIVE IRIS ATROPHY ICE SYNDROME MANAGEMENT: ENDOCAPSULAR ARTIFICIAL IRIS PLACEMENT FOLLOWED BY DSAEK

TWO-STEP PROGRESSIVE IRIS ATROPHY ICE SYNDROME MANAGEMENT: ENDOCAPSULAR ARTIFICIAL IRIS PLACEMENT FOLLOWED BY DSAEK

Published 2023 - 27th ESCRS Winter Meeting

Reference: O28 | Type: Free Paper Submission | DOI: 10.82333/bs6k-0m04

Authors: Inês Coelho-Costa* 1 , João Pinheiro-Costa 2 , Fernando Falcão-Reis 3 , Tiago Monteiro 4 , Manuel Falcão 2

1Ophthalmology,Centro Hospitalar Universitário de São João,Porto,Portugal, 2Ophthalmology,Centro Hospitalar Universitário de São João,Porto,Portugal;Department of Surgery and Physiology, Faculty of Medicine,University of Porto,Porto,Portugal;Ophthalmology,Hospital CUF Porto,Porto,Portugal, 3Ophthalmology,Centro Hospitalar Universitário de São João,Porto,Portugal;Department of Biomedicine, Faculty of Medicine,University of Porto,Porto,Portugal, 4Ophthalmology,Hospital de Braga,Braga,Portugal;Life and Health Sciences Research Institute (ICVS), School of Health Sciences,University of Braga,Braga,Portugal;Ophthalmology,Hospital CUF Porto,Porto,Portugal

Purpose

A case report of Iridocorneal Endothelial Syndrome (ICE) Syndrome managed with two-step surgery of endocapsular artificial iris placement followed by Descemet’s Stripping Automated Endothelial Keratoplasty (DSAEK)

Setting

A 54-year-old female presented with complaints of glare and progressive visual loss OS with a corrected distance visual acuity (CDVA) OS of 20/100. The patient had grade 1 corneal edema with a “beaten bronze” appearance on specularly reflected light, pseudopolycoria and a nuclear sclerotic cataract.

Methods

The diagnosis of nuclear cataract and Progressive Iris Atrophy ICE syndrome was made, and the patient underwent uneventful phacoemulsification with capsular bag placement of an Acrysof SA60AT IOL combined with pseudopolycoria repair using a REPER endocapsular Model A artificial iris. Six months later, the patient was submitted to a DSAEK procedure. 

Results

Six months post DSAEK CDVA was 20/32 with no corneal edema and normal intraocular pressure.

Conclusion

This novel two-step surgical approach, combining phacoemulsification and endocapsular foldable iris prosthesis placement followed by DSAEK, may be considered a promising option to successfully treat Progressive Iris Atrophy ICE syndrome patients.