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Novel mechanism of decreased iris vasculature density after cosmetic iris implants
  1. Jason A Goldsmith1,
  2. Prateek Agarwal1,2,
  3. Scott D Smith1 and
  4. Rony R Sayegh3
  1. 1Eye Institute, Cleveland Clinic, Abu dhabi, UAE
  2. 2Eye Centre, Mid Yorkshire Hospitals NHS Trust, Wakefield, UK
  3. 3Cleveland Clinic Cole Eye Institute, Cleveland, Ohio, USA
  1. Correspondence to Dr Prateek Agarwal; dr.prateekagarwal{at}


A 25-year-old man presented with decreased vision in both eyes, approximately 4 years following bilateral bright ocular cosmetic iris implantation. On examination, he was found to have bilateral elevated intraocular pressures, anterior chamber cells and flare, chronic peripheral anterior synechiae and significantly reduced endothelial cell counts. Ultrasound biomicroscopy demonstrated compression of the peripheral iris, resulting in synechial angle closure in both eyes. Surgical removal of the implants was performed without additional complication. On removal, bilateral iris atrophy was evident with non-reacting pupils and permanent mydriasis. Optical coherence tomography angiography showed a reduction in iris vasculature density that is more pronounced in the area of the iris atrophic defects. This case suggests that cosmetic iris implants may compress iris vasculature, resulting in decreased iris perfusion resulting in atrophic mydriasis and iris defects. This is a potential novel mechanism for complications in eyes with cosmetic iris implants.

  • iris
  • anterior chamber
  • glaucoma

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  • Contributors JAG: contribution in conception of the manuscript. PA: design, formatting and rephrasing the manuscript. SDS: contribution in acquisition of data and analysis. RRS: contribution in interpretation and analysis and take home summary from the case.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Patient consent for publication Obtained.

  • Provenance and peer review Not commissioned; externally peer reviewed.

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