Urrets-Zavalia Syndrome After Cataract Surgery: A Case Report

To describe a case of Urrets-Zavalia Syndrome after uneventful cataract surgery

A 69 woman was operated for cataract in her left eye at the Operative Unite of Ophthalmology, Hospital of Chiari, Italy in October 2023. She had already undergone cataract surgery in her right eye the month before by the same surgeon without any complications

She presented a nuclear++ cataract in her left eye, normal IOP, pre-operative BCVA was 0.7. She had a mild corneal endothelial dystrophy, as in the contralateral eye. She underwent cataract surgery without any complications. The day after she reported pain in the eye: the slit lamp examination of her left eye showed a mild conjunctival hyperaemia, corneal edema ++ and Descemet's membrane folds, the IOP was 27 mmHg. Topical dorzolamide+timolol eye drops 2 times per day were added to her therapy. Two days after she presented a quite clear cornea, moderate inflammation in the anterior chamber, and a wide rigid pupil with some posterior adherences in the superior part and initial iris atrophy. Fundus examination was normal. Fluorescein angiography, oct macula and rnfl, and visual field test did not reveal pathological signs. Two months after the cornea was clear, IOP was 10 mmHg, no cellularity in the anterior chamber, but still dilated pupil, iris atrophy in the superior part and some posterior adherences. BVCA was 0.5. She was a candidate for an artificial iris implant. After the implant BCVA raised till 0.75 and the patient solved her light discomfort

Urrets-Zavalia Syndrome can rarely follow even an uneventful cataract surgery and should be considered in patients showing dilated pupil, iris atrophy and posterior adherences. An artificial iris implant could be a viable option