A case of iridoschisis with partial lens dislocation in both eyes.

BACKGROUND: Iridoschisis is a rare condition that primarily affects individuals aged 60-70 years. The predominant characteristics of iridoschisis involve the tissue splitting and separation of the iris stromal layers, often resulting in two distinct layers and the presence of floating fibers in the anterior chamber. This article reports the case of a 48-year-old male with iridoschisis with partial lens dislocation in both eyes. CASE PRESENTATION: Trauma is the leading factor in the development of iridoschisis. However, there is no documented case of ocular trauma in the patient's medical history. Visible white atrophic fibers were observed bilaterally in the anterior iris stroma of both eyes of the individual, accompanied by a small quantity of iris tissue within the anterior chamber. In this instance, the magnitude of the iridoschisis corresponded with the degree of lens dislocation. We were apprised that the patient had regularly used a cervical massager for a prolonged period of time, positioning it upon the ocular region. Frequent stimulation of both eyes with excessive force resulted in the development of iridoschisis and the partial dislocation of the lens.During the initial surgical procedure, phacoemulsification (Phaco) was carried out on the left eye without the placement of an intraocular lens (IOL). Following a two-month interval, we proceeded with the IOL suspension. Subsequently, the right eye underwent Phaco, accompanied by the implantation of an IOL. After closely monitoring the patient's progress for two months, it was evident that their vision had significantly improved, substantiating the success of the surgical interventions. CONCLUSIONS: This finding posits that the recurrent friction applied to both eyes may induce iridoschisis and various ocular complications. In the event of ocular intricacies manifesting, expeditious medical intervention becomes imperative.

Efficiency comparison with fovea-sparing internal limiting membrane peeling and complete internal limiting membrane peeling for treating myopic traction maculopathy.

PURPOSE: To explore whether the efficacy of fovea-sparing internal limiting membrane peeling (FS-ILMP) is better than that of complete internal limiting membrane peeling (ILMP). METHODS: This retrospective clinical study included 34 cases (34 eyes) with myopic traction maculopathy collected from June 2017 to February 2019. Twenty-three-gauge (23-G) pars plana vitrectomy (23G PPV) was performed on all patients. In the FS-ILMP group, 18 eyes retained the internal limiting membrane (ILM) of about 1 to 1.5 papillary diameter centered on fovea centralis, while in the standard ILMP group, the ILM was completely removed from 16 eyes. The best corrected visual acuity (BCVA), central foveal thickness (CFT), and other indexes were collected before and 6 months after surgery. RESULTS: There was no significant difference in baseline clinical characteristics between the two groups. CFT and BCVA were significantly improved in both FS-ILMP and standard ILMP group, but the postoperative BCVA of the FS-ILMP group was significantly better than that of the standard ILMP group (P < 0.001). Two cases of subretinal effusion in macula were recorded in the FS-ILMP group, and three eyes in the standard ILMP group developed macular holes after surgery. Although both treatments relieved the mechanical traction of macular fovea, the patients in the FS-ILMP group showed better clinical outcomes in various aspects. CONCLUSION: These results improved our understanding of the clinical application of vitrectomy combined with preservation of ILM upon the fovea centralis, which might lay a foundation for in-depth study on the treatment of myopic traction maculopathy.