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Traumatic iris defect
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 Iris defect after airbag trauma |
A 23-year-old woman sustained an airbag injury to her right eye that resulted in an iris defect. The inflammation has resolved and the patient is symptomatic from this injury. How do you proceed?
The patient is phakic without any cataractous changes. A surgical procedure to repair the iris carries the risk of inducing an iatrogenic cataract in this young patient.
If the patient had an existing cataract from the initial trauma, then the iris could be retracted with iris hooks during phacoemulsification.
Once the new IOL is in the capsular bag, the pupil can be constricted with miotic agents and the iris can be sutured back in place.
For this patient, the initial treatment is with a specialty contact lens that blocks the peripheral iris. So far, she has done well with the contact, which addresses her symptoms from the iris defect as well as corrects her mild myopia. Sometimes the best surgery is no surgery at all.