IRVINE-GASS SYNDROME AND RETROPUPILLARY IRIS-CLAW INTRAOCULAR LENS : CASE REPORT

Irvine-Gass syndrome is a postsurgical cystoid macular edema (CME) which is the most common cause of poor

visual acuity after cataract surgery.

The aim of this observation was to establish the relationship between Irvine-Gass syndrome and retropupillary iris-claw intraocular lens (IOL).

We conducted a study at the ophthalmology department of the university hospital of Habib Bourguiba Sfax between January  2015 and December 2017.

We conducted a monocentric longitudinal interventional study, initially retrospective then prospective about 45 eyes of 43 patients operated by retropupillary iris-claw IOL at the ophthalmology department of the university hospital of Habib Bourguiba Sfax between January  2015 and December 2017. We gathered the data of the clinical assessments and the complementary examinations by doing post-operative OCT chek-up. We studied the possible complications in the middle-term, their incidences , as well as their methods of management.

Among the post-operative complications, we observed 2 cases (4.4%) of CME diagnosed within 12 weeks postoperatively. In both cases, the discovery was fortuitous during the realization of a postoperative macular OCT check-up. Retinal fluorescein angiography showed diffuse macular edema resulting in “flower petal” appearance with papilledema. Macular OCT objectified a CME with the presence of a serous retinal detachment .The first patient was operated for a subluxated traumatic cataract with pupilloplasty and primary implantation. The 2nd one has undergone secondary implantation following complicated cataract surgery.  In the two cases , the macular edema has evolved favourably under a well-conducted treatment with an improvement in visual acuity .

We conducted a monocentric longitudinal interventional study whose aim was to evaluate implants clipped to the posterior surface of the iris in the correction of aphakia. Among the complications that were identified, Irvine Gass syndrome was diagnosed in 2 patients with a good evolution after treatment.