Bang Seung Pil, Jun Jong Hwa
Department of Ophthalmology, Keimyung University School of Medicine, #56, Dalseong-ro, Jung-gu, Daegu, 700-712, Korea.
BMC Ophthalmol. 2017 Apr 4;17(1):39. doi: 10.1186/s12886-017-0432-4.
A large iris defect or extensive iridodialysis can be an intractable cause of visual disturbance, photophobia, glare, monocular diplopia, or cosmetic deformity. The implantation of an artificial iris substitute could be an effective option, but this can cause a reduction in endothelial cell density. We succeeded in the anatomical restoration of iris tissue that was totally dialyzed out of the eye, and was preserved in cold balanced salt solution for 8 h. Engrafted iris tissue was maintained within the aqueous humor.
A 71-year-old man was referred to our clinic for management of an iatrogenic total iridodialysis. The totally dialyzed iris tissue was immediately preserved in sterile cold balanced salt solution and packed in a sterile biopsy bottle that was surrounded with ice cubes. Under general anesthesia, a pars plana vitrectomy was performed to remove the remaining lens cortex and vitreous fiber anterior to the equator. A sulcus-positioned intraocular lens (IOL) was repositioned and fixed by ab externo scleral sutures. Preserved iris tissue was inserted and ironed using both iris spatula and ocular viscoelastic devices. Five-point ab interno scleral sutures were made 1.0 mm posterior to the limbus.
The engrafted iris was successfully maintained for 6 months and did not undergo any atrophic change or depigmentation, which may be caused by primary implantation failure due to a blocked blood supply.
大的虹膜缺损或广泛的虹膜根部离断可能是导致视觉障碍、畏光、眩光、单眼复视或外观畸形的棘手原因。植入人工虹膜替代物可能是一种有效的选择，但这可能会导致内皮细胞密度降低。我们成功地对从眼中完全脱出并在冷平衡盐溶液中保存8小时的虹膜组织进行了解剖学修复。移植的虹膜组织保留在房水中。
一名71岁男性因医源性完全性虹膜根部离断被转诊至我院。完全离断的虹膜组织立即保存在无菌冷平衡盐溶液中，并装入一个用冰块包围的无菌活检瓶中。在全身麻醉下，进行了玻璃体切除手术，以清除赤道前方剩余的晶状体皮质和玻璃体纤维。通过外路巩膜缝线重新定位并固定了沟内植入的人工晶状体（IOL）。使用虹膜铲和眼用粘弹性装置插入并熨平保存的虹膜组织。在角膜缘后方1.0毫米处进行了五点内路巩膜缝合。
移植的虹膜成功维持了6个月，未发生任何萎缩性变化或色素脱失，而这些变化可能是由于血液供应受阻导致的初次植入失败所致。
