Iris-Claw Lens Implantation in a Patient with Iridoschisis

Patient: Male, 47-year-old Final Diagnosis: Bilateral iridoschisis Symptoms: Visual loss Medication: — Clinical Procedure: Pars plana vitrectomy • lensectomy • artificial lens implantation Specialty: Ophthalmology OBJECTIVE: Rare co-existance of disease or pathology BACKGROUND: Iridoschisis is a rare condition defined as a separation of anterior iris stroma from the posterior stroma and muscle layers. The etiopathogenesis of iridoschisis is not fully understood. We report the case of uveitis-glaucoma-hyphema (UGH) syndrome related to the iris-claw lens implantation in a patient with iridoschisis, and propose an alternative approach to aphakia correction. CASE REPORT: A 47-year-old male was referred to our department with bilateral iridoschisis, associated lens subluxation, mature cataract, and secondary glaucoma. The patient underwent bilateral surgery, with entirely different anterior segment results depending on the method of artificial lens implantation. To the best of our knowledge, iris-claw implantation in iridoschisis and the potential association of iridoschisis with increased risk of UGH syndrome, have not been reported previously. CONCLUSIONS: Due to the possibly increased risk of UGH syndrome in patients with iridoschisis, one may consider treating aphakia by implantation of scleral fixated lenses, rather than iris-claw lenses.