Офтальмохирургия (Oct 2020)
Optical-reconstructive treatment of a patient with essential-mesodermal dystrophy of the iris
Abstract
Essentially mesodermal dystrophy of the iris is a type of iridocorneal endothelial syndrome and has a chronic progressive course. It stems from the local fibrosis in the outer border of the iris, which subsequently leads the peripheral iris to pull up and the pupil to deform.Purpose. To evaluate outcome of the modern high-tech surgical treatment, which allows to increase visual functions, prevent decompensation of intraocular pressure and achieve the desired cosmetic effect.Material and methods. Patient R., 48 y.o., with diagnosed OU Essential-mesodermal dystrophy of the iris, low hyperopia, astigmatism, presbyopia. In order to prevent the development of secondary glaucoma and to correct refractive anomalies, phacoemulsification with implantation of a multifocal toric IOL, synechiotomy, and iris plastic surgery were performed. The calculation of MTIOL was performed using the data from the VERION™ Image Guided System navigation computing complex (Alcon, USA) and IOLMaster® 700 optical biometer (Carl Zeiss, Germany).Results. During follow-up examinations the patient noticed an increase in visual acuity with stabilization by the 6th month, a significant decrease in undesirable optical phenomena (glare, halo) and was satisfied with the postoperative cosmetic result. The level of intraocular pressure stabilized by the 6th month after surgery and was within the reference range by the 9th month. No intraoperative complications were observed. Control UBM scans showed OU transparent cornea, anterior chamber shallower than the average depth, stratified stroma of the iris, moderate anterior chamber angle, intact ciliary body, pupil in the center, IOL in capsule bag.Conclusion. The case describes outcome of successful surgical treatment of rare variety of iridocorneal endothelial syndrome, increase in visual functions, achievement of the desired cosmetic effect, and improvement in the quality of life of the working age patient.
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