Department of Ophthalmology, Hainan Hospital of Chinese PLA General Hospital, No 80. Jianglin Road, Haitang Bay, Sanya, 572013, China.
Senior Department of Ophthalmology, Chinese PLA General Hospital, Haidian District, No 28. Fuxing Road, Beijing, 100853, China.
BMC Ophthalmol. 2023 Aug 21;23(1):362. doi: 10.1186/s12886-023-03105-x.
Traumatic aniridia occurs when the iris is extruded from the eye and is often accompanied by lens injuries. However, traumatic aniridia due to dislocation of the iris into the vitreous cavity without lens damage has never been reported.
A 30-year-old man presented with visual loss and pain for 6 h after a thin wire injured his right eyeball. Ophthalmologic examinations manifested a 2 mm full-thickness corneal laceration and total hyphema. An intact clear lens, healthy attached retina, and almost complete iris tissue in the vitreous cavity were found after resolution of hyphema the next day. Further examination revealed that the defect in the zonule below the corneal wound was the path for the iris to enter the vitreous cavity. The patient opted for nonsurgical treatment until pigment granules and opacity were observed in the vitreous cavity after 50 days. Vitrectomy was performed to remove the dislocated iris.
The presentation of this unique case indicates that the torn iris was displaced to the vitreous cavity with an intact lens and missing local zonula instead of out the corneal laceration after a penetrating injury. The type of injury, mechanism, and force on the spot may contribute to the occurrence of this rare condition. Instead of artificial irises, tinted glasses were more appropriate treatment option for this patient. Peripheral retinal examination was essential in the management of this case. In such cases, the iris in the vitreous cavity should be resected to prevent complications.
外伤性无虹膜是指虹膜从眼球中脱出，通常伴有晶状体损伤。然而，由于虹膜脱位进入玻璃体腔而没有晶状体损伤的外伤性无虹膜尚未见报道。
一名 30 岁男性，右眼被细铁丝刺伤 6 小时后出现视力丧失和疼痛。眼科检查显示 2mm 全层角膜裂伤和全血。次日血吸收后发现完整的透明晶状体、健康的附着视网膜和几乎完整的虹膜组织位于玻璃体腔中。进一步检查显示，角膜伤口下方的悬韧带缺损是虹膜进入玻璃体腔的途径。患者选择非手术治疗，50 天后玻璃体腔中出现色素颗粒和混浊。行玻璃体切除术切除脱位的虹膜。
该特殊病例的表现表明，穿透性损伤后，撕裂的虹膜在完整的晶状体和缺失局部悬韧带的情况下移位到玻璃体腔，而不是从角膜裂伤处脱出。受伤类型、机制和现场受力可能导致这种罕见情况的发生。对于该患者，有色眼镜比人工虹膜更适合作为治疗选择。在这种情况下，应切除玻璃体腔中的虹膜以防止并发症。
