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Ophthalmic Images
January 14, 2016

Bilateral Iris Prolapse Secondary to Eye Rubbing Following Cataract Surgery

Author Affiliations
  • 1Department of Ophthalmology, University of Virginia, Charlottesville
JAMA Ophthalmol. 2016;134(1):e153610. doi:10.1001/jamaophthalmol.2015.3610

A woman in her late 50s underwent uneventful sequential cataract surgery by phacoemulsification (left eye, then right eye 1 week later). Both eyes had a normal postoperative appearance immediately following surgery; however, her postoperative course was marked by excessive eye rubbing attributed to seasonal allergies. At her 1-month postoperative visit, the patient complained of a 1-week history of “red eyes” and photophobia. She was found to have bilateral iris prolapse at the sites of her corneal incisions. This was initially managed with anterior chamber injection of cefuroxime in both eyes. Two days later, the patient was referred for persistent iris prolapse with worsening photophobia and injection (Figure). Visual acuity was 20/40 OD and 20/25 OS. She underwent bilateral repair with excision of necrotic iris tissue and recreation of the pupil. Following repair, the patient wore bilateral eye shields to prevent eye rubbing. One month later, best-corrected visual acuity was 20/20 OU without recurrence.

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