Instituto Oftalmologico Fernandez-Vega, Avda. Dres. Fernandez-Vega, 34, 33012, Oviedo, Spain.
Fundacion de Investigacion Oftalmologica, University of Oviedo, Oviedo, Spain.
BMC Ophthalmol. 2022 Nov 30;22(1):459. doi: 10.1186/s12886-022-02650-1.
Additive cosmetic implants (NewColorIris, Kahn Medical Devices, Panama City, Panama) are placed in the anterior chamber, in order to externally change iris color. There is a lack of robust clinical long-term prospective studies regarding the safety of these devices, as they have been related to the early-onset presentation of corneal decompensation, elevated intraocular pressure (IOP), uveitis and hyphema. However, in this case report some mild complications started to manifest unexpectedly late: 15 years after an uneventful procedure.
A 41-year-old Caucasian woman presented with blurred vision in both eyes over the last 6 months. Fifteen years earlier, she had undergone bilateral implantation of additive iris implants for aesthetic purposes, without any complication or ocular trauma during the follow-up. Ocular examination showed bilateral mild corneal edema, iris atrophy, and presence of pigment in the endothelium. Increased IOP (28 mmHg) was identified in the right eye. Anterior segment optical coherence tomography (AS-OCT) confirmed the decentration of the iris implant from the pupillary axis in that eye. Gonioscopy demonstrated pigment dispersion in both eyes, as well as a tendency to bilateral angle closure, that was also illustrated by AS-OCT analysis. Endothelial cell count was 1268 cells/mm in the right eye and 1122 cells/mm in the left eye. The presence of both implants was affecting corneal endothelium and anterior chamber angle in both eyes, and additionally, the decentration of the device in the case of the right eye led to secondary ocular hypertension in that eye.
Cosmetic implants in contact to the iris can remain quiescent for years, leading to possible complications that can present even in the long-term. The degree of implant decentration, the stage of angle closure disease and the magnitude of pigment dispersion may be some important factors related to the onset time of complications in these cases.
添加性美容植入物（NewColorIris，Kahn Medical Devices，巴拿马城，巴拿马）被放置在前房内，以对外改变虹膜颜色。由于这些设备与角膜失代偿、眼内压升高、葡萄膜炎和前房积血的早期发病有关，因此缺乏关于这些设备安全性的稳健临床长期前瞻性研究。然而，在本病例报告中，一些轻度并发症开始出乎意料地延迟出现：在无并发症的手术 15 年后。
一位 41 岁的白种女性，双眼视力模糊超过 6 个月。15 年前，她因美容目的接受了双侧添加性虹膜植入物植入，随访期间无任何并发症或眼部外伤。眼部检查显示双眼轻度角膜水肿、虹膜萎缩和内皮色素沉着。右眼眼压升高（28mmHg）。眼前节光学相干断层扫描（AS-OCT）证实右眼虹膜植入物从瞳孔轴偏心。房角镜检查显示双眼色素播散，以及双侧房角关闭的趋势，AS-OCT 分析也说明了这一点。右眼内皮细胞计数为 1268 个/毫米，左眼内皮细胞计数为 1122 个/毫米。两个植入物都影响了双眼的角膜内皮和前房角，此外，右眼器械的偏心导致了该眼的继发性眼高压。
与虹膜接触的美容植入物可以多年保持静止，导致可能的并发症，甚至在长期内也可能出现。植入物偏心程度、房角关闭疾病的阶段和色素播散的程度可能是与这些病例并发症发病时间相关的一些重要因素。
