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January 2011

This Month's BLINK
Prolapsed Iris
Written by Mark D. Clark, CRA, Wake Forest University Eye Center, Winston-Salem, N.C.
Edited by Michael P. Kelly, CPT.
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(PDF 208 KB)

January 2011 Blink

A 10-year-old boy was referred to our clinic where examina­tion revealed a 4.5-mm inferonasal corneal laceration in the left eye that came to an apex at 9 o’clock. Visual acuity was 20/100 in the injured eye and 20/20 in the right eye. He had a prolapsed iris that extended out through the open globe. The corneal laceration was caused by a knife that penetrated and was withdrawn from the eye, pulling the iris out through the corneal perforation.

Open globe repair was performed that day. After administering general anesthesia, a corneal paracentesis was done superotem­porally. Carbachol ophthalmic solution and sodium hyaluronate were injected. The exposed iris was necrotic and could not be returned to its original position. It was excised and an iris sweep was used to replace the remaining iris into the wound. Six inter­rupted corneal sutures were positioned and then turned to place the knot inside the anterior chamber. After the paracentesis was hydrated, it was confirmed that the anterior chamber was properly sealed. The patient tolerated the procedure well and, within three weeks, visual acuity had improved to 20/60 and 20/40 with pin­hole.


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