A case report on cataract surgery in eyes with bilateral inferior iridoschisis

Purpose - The purpose of the paper is to report a case of bilateral inferior iridoschisis who underwent cataract surgery with intraocular lens implantation successfully with the help of iris hooks or pupillary expanders. Design/methodology/approach - A 71-year-old male presented with inferior iridoschisis in both eyes, history of angle closure glaucoma (ACG), cataract and shallow anterior chamber (AC) angles inferiorly. A localized area of iris stroma is cleaved in two with anterior atrophic portion disintegrating into fibrils from the posterior stroma, and muscle layer is termed as iridoschisis. Iridoschisis is a rare condition associated with fibrillary iris degeneration, narrow drainage angles and cataract. Findings - Preoperative and postoperative ocular examination, including visual acuity, intraocular pressure and degrees of iris damage, was evaluated. Cataract surgery was performed under topical anesthesia with flexible iris hooks. There were no intraoperative complications whereas marked corneal edema was shown at immediate postoperative period but subsided completely in two weeks’ time. Visual acuity improved from 20/60 to 20/25. Practical implications - This case report demonstrates that while iridoschisis care during cataract surgery has been reported to be difficult, cataract extraction was managed using iris hooks. Originality/value - This paper reports the successful management of cataract in a patient with bilateral inferior iridoschisis.