Sathish Srinivasan1, Mark Batterbury, Paul Hiscott. 1. St Paul's Eye Unit, Royal Liverpool and Broadgreen University Hospitals, NHS Trust, Liverpool, United Kingdom. sathish@tiscali.co.uk
Abstract
PURPOSE: To report a case of localized bullous keratopathy and total corneal decompensation secondary to iridocorneal touch in iridoschisis. DESIGN: Single interventional case report with pathologic correlation. METHODS: An 80-year-old man with bilateral iridoschisis presented with loss of vision in the left eye (OS). Examination of the OS showed shallow anterior chamber (AC), cortical cataract, and free-floating iris fibers causing iridocorneal touch, leading to localized bullous keratopathy and total corneal decompensation. Ultrasound biomicroscopy (UBM) confirmed the area of iridocorneal contact. RESULTS: Penetrating keratoplasty combined with cataract extraction and posterior chamber lens implantation was performed in the OS. Histopathology of the corneal button showed features of corneal edema and endothelial cell loss with evidence of iridocorneal contact. CONCLUSIONS: Iridoschisis is an uncommon cause of bullous keratopathy and corneal decompensation. Patients with iridoschisis may need specular microscopy to determine the status of the corneal endothelium.
PURPOSE: To report a case of localized bullous keratopathy and total corneal decompensation secondary to iridocorneal touch in iridoschisis. DESIGN: Single interventional case report with pathologic correlation. METHODS: An 80-year-old man with bilateral iridoschisis presented with loss of vision in the left eye (OS). Examination of the OS showed shallow anterior chamber (AC), cortical cataract, and free-floating iris fibers causing iridocorneal touch, leading to localized bullous keratopathy and total corneal decompensation. Ultrasound biomicroscopy (UBM) confirmed the area of iridocorneal contact. RESULTS: Penetrating keratoplasty combined with cataract extraction and posterior chamber lens implantation was performed in the OS. Histopathology of the corneal button showed features of corneal edema and endothelial cell loss with evidence of iridocorneal contact. CONCLUSIONS: Iridoschisis is an uncommon cause of bullous keratopathy and corneal decompensation. Patients with iridoschisis may need specular microscopy to determine the status of the corneal endothelium.