Study: Pseudophakic eyes at risk of iris bombé

SAN FRANCISCO — Pseudophakic patients with deep anterior chambers should be observed carefully for possible symptoms of iris bombé, according to a poster presentation here at the American Society of Cataract and Refractive Surgery meeting.

Ryoji Yamakawa, MD, sought to understand the risk factors associated with this disease, which leads to uncontrolled IOP if left untreated.

“Iris bombé is often seen in phakic eyes, but in pseudophakic eyes has been rarely reported,” Dr. Yamakawa said.

The noncomparative case series looked at iris bombé in eight pseudophakic eyes of seven patients at Kurume University Hospital and Tobata Kyoritz Hospital between August 2002 and September 2005.

The study included two men and five women, with an average age of 62.5 years. One eye had uveitis, one had chronic angle-closure glaucoma, and six had proliferative diabetic retinopathy.

The study found that iris bombé developed in one uveitic eye and one eye with chronic angle-closure glaucoma after phacoemulsification with IOL implantation and vitrectomy. All eyes had ongoing inflammation, small continuous curvilinear capsulorrhexis and poor pupillary dilation. High IOP was observed in four eyes and was lowered by laser iridotomy.

In all eyes, iris bombé was resolved with laser iridotomy. However, patients with proliferative diabetic retinopathy required several treatments because of repeated closure of iridotomies.

“It must be recognized that persistent inflammation, small CCC and poor pupillary dilation are risk factors for iris bombé,” Dr. Yamakawa said.