Weseley A C, Freeman W R
Ann Ophthalmol. 1983 Oct;15(10):955-9, 963-4.
Iridoschisis has been known as a rare entity for the past 60 years, since its first description by Schmitt. It has been reported most frequently in eyes with a history of trauma or one of the glaucomas. While freely floating fibers of disrupted iris mesenchyma may be seen to brush against the corneal endothelium in many patients, there has never been a report of corneal compromise secondary to iridoschisis. A patient with bilateral glaucoma is described. Iridoschisis was present in one eye, and specular microscopy revealed a marked decrease in cell density (600 cells per square millimeter) directly over the split iris fibers. A high degree of polymegethism was also present over the involved sector of iris. Cell counts and morphological findings elsewhere in the cornea were normal for the patient's age. Iridoschisis may be a hitherto unrecognized cause of endothelial decompensation. In selected cases, prophylactic surgical iridectomy should be considered in order to remove the disrupted iris fibers that may play a role in corneal changes.
自施密特首次描述以来，在过去60年里，虹膜劈裂症一直被视为一种罕见病症。它最常出现在有外伤史或患有青光眼的眼睛中。虽然在许多患者中可看到虹膜间充质的游离纤维擦过角膜内皮，但从未有过虹膜劈裂症继发角膜损伤的报道。本文描述了一名双侧青光眼患者。其中一只眼睛存在虹膜劈裂症，镜面显微镜检查显示，在劈裂的虹膜纤维正上方，细胞密度显著降低（每平方毫米600个细胞）。在受累的虹膜区域还存在高度的细胞大小不均一性。角膜其他部位的细胞计数和形态学检查结果与患者年龄相符。虹膜劈裂症可能是一种迄今未被认识到的内皮失代偿原因。在某些情况下，应考虑预防性手术虹膜切除术，以去除可能在角膜变化中起作用的劈裂虹膜纤维。
