In pseudophakic eyes, isolated total aniridia following a nonperforating blunt trauma, without any apparent dehiscence or extension of the cataract incision, has been rarely reported in the literature. Here we describe a case of posttraumatic massive hyphema followed by complete aniridia in a patient who had undergone cataract surgery 18 months before. A comprehensive diagnostic assessment, including ultrasound biomicroscopy (UBM; i.e. 50-MHz single-element mechanical sector scanner), has been performed within few days from the hyphema reabsorption. To our knowledge, UBM findings of this condition have not been documented previously. There are two possible explanations for the hitherto described aniridia secondary to traumatic iridodialysis: (1) the iris was expulsed through the quickly transient opening of the cataract incision; and (2) the iris remained within the eye and then it was phagocyted by macrophages and/or trabecular meshwork cells. The first hypothesis has already been suggested by other authors, who have reported similar posttraumatic outcomes but always in eyes with recent cataract surgery. However, our UBM images, revealing a band of echogenic particles at the level of the anatomical iris position, cannot definitely rule out the second deduction. This intriguing possibility has been also indirectly suggested by Ball et al as well as speculatively supported by several findings observed in experimental models of phagocytosis. In fact, the phagocytic properties of both macrophages and trabecular meshwork cells could theoretically explain the missing disinserted iris which, even partially or totally remaining within the eye, should be identified as a nonself material.
Total aniridia after nonperforating trauma of a pseudophakic eye: ultrasound biomicroscopic findings
PARMEGGIANI, Francesco;CAMPA, Claudio;
2007
Abstract
In pseudophakic eyes, isolated total aniridia following a nonperforating blunt trauma, without any apparent dehiscence or extension of the cataract incision, has been rarely reported in the literature. Here we describe a case of posttraumatic massive hyphema followed by complete aniridia in a patient who had undergone cataract surgery 18 months before. A comprehensive diagnostic assessment, including ultrasound biomicroscopy (UBM; i.e. 50-MHz single-element mechanical sector scanner), has been performed within few days from the hyphema reabsorption. To our knowledge, UBM findings of this condition have not been documented previously. There are two possible explanations for the hitherto described aniridia secondary to traumatic iridodialysis: (1) the iris was expulsed through the quickly transient opening of the cataract incision; and (2) the iris remained within the eye and then it was phagocyted by macrophages and/or trabecular meshwork cells. The first hypothesis has already been suggested by other authors, who have reported similar posttraumatic outcomes but always in eyes with recent cataract surgery. However, our UBM images, revealing a band of echogenic particles at the level of the anatomical iris position, cannot definitely rule out the second deduction. This intriguing possibility has been also indirectly suggested by Ball et al as well as speculatively supported by several findings observed in experimental models of phagocytosis. In fact, the phagocytic properties of both macrophages and trabecular meshwork cells could theoretically explain the missing disinserted iris which, even partially or totally remaining within the eye, should be identified as a nonself material.I documenti in SFERA sono protetti da copyright e tutti i diritti sono riservati, salvo diversa indicazione.
