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Ophthalmology and Visual Sciences

EyeRounds.org

EyeRounds Online Atlas of Ophthalmology

Contributor: William Charles Caccamise, Sr, MD, Retired Clinical Assistant Professor of Ophthalmology, University of Rochester School of Medicine and Dentistry

*Dr. Caccamise has very generously shared his images of patients taken while operating during the "eye season" in rural India as well as those from his private practice during the 1960's and 1970's. Many of his images are significant for their historical perspective and for techniques and conditions seen in settings in undeveloped areas.

Iris prolapse

Postop prolapse of iris

postop prolapse of iris

Following cataract surgery in the pre-Kelman era, prolase of the iris usually occurred within 48 hours. However, there were cases that occurred up to 2 weeks postop. Except for minute asymptomatic prolapses, immediate surgical repair was indicted. Marked irritation surrounding the prolapsed iris in the photograph could presage increased inflammatory problems in that eye. The other eye must be watched for the remote possibility of sympathetic ophthalmia.

postop prolapse of iris

Prolapse of the iris following cataract surgery

prolapse of the iris following cataract surgery

The iris prolapsed through the entire temporal half of the 180 degree limbal incision. Immediate surgical repair (excision of the prolapsed iris) was indicated. This was a bugbear for cataract surgeons prior to the Kelman small-incision era.

Prolapsed iris following intracapsular cataract surgery with 180 degree incision

iris: prolapsed iris following intracapsular cataract surgery with 180 degree incision

In the era of the 180 degree superior limbal incision, iris prolapse was an occasional post-op complication.

cataract: iris prolapse as a postop complication of recent cataract surgery.

An iris prolapse was an infrequent complication of intracapsular cataract surgery with an incision of 180 degrees. Modern small-incision cataract surgeons rarely if ever have to face this problem.

Iris prolapse following intracapsular cataract surgery without sutures

iris prolapse following intracapsular cataract surgery without sutures

Intracapsular cataract surgery without sutures all too often presented this complication postoperatively. The treatment was excision of the prolapsed iris followed by tight closure of the wound. Frequently, air was injected into the anterior chamber during and following the repair in order to protect the vitreous face and to discourage loss of vitreous during the procedure.

Postop cataract complication: massive prolapse of the iris

postop cataract complication: massive prolapse of the iris

This was an all too frequent complication when intracapsular cataract surgery was performed without the security of sutures to obtain tight wound closure.Treatment was to excise the prolapsed iris and to close the wound with an adequate number of sutures.

postop cataract complication: massive prolapse of the iris

gaping von Graefe incision - no sutures

 


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Ophthalmic Atlas Images by EyeRounds.org, The University of Iowa are licensed under a Creative Commons Attribution-NonCommercial-NoDerivs 3.0 Unported License.

last updated: 02-08-2008
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