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June 2012, Vol 130, No. 6 >

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Small Case Series | June 2012

Two Cases of Cosmetic Iris Implant Explantation Secondary to Uveitis, Glaucoma, and Corneal Decompensation

Peter B. Veldman, MD; Irmgard Behlau, MD; Eduardo Soriano, MD; Jay C. Starling, MD; Roberto Pineda, MD
Arch Ophthalmol. 2012;130(6):787-789. doi:10.1001/archophthalmol.2011.2594.
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Cosmetic alteration of the iris color has long intrigued individuals. This has been accomplished with cosmetic contact lenses and most recently with intraocular artificial iris implants. We report 2 cases of uveitis, glaucoma, and corneal decompensation in women who underwent bilateral simultaneous implantation of a non–US Food and Drug Administration–approved cosmetic iris implant (NewColorIris). This device is a plate-styled colored silicone prosthesis designed for placement in the anterior chamber. Both patients had traveled to Panama City, Panama, to undergo the elective procedure. After surgery, both developed variants of an ocular complex comprising uveitis, glaucoma, and corneal decompensation and requiring explantation of the cosmetic iris implants. Various in situ and extirpated imaging techniques demonstrate implant placement, size, and surface characteristics that likely contributed to the ocular complications in these 2 cases.
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Figure 1. Findings in case 1. A, Cosmetic iris implant. B, Anterior segment optical coherence tomographic image demonstrating in situ apposition of the disc to the corneal endothelium peripherally. Decreased endothelial cell counts with irregular cellular morphology in the right (C) and left (D) eyes. Ave indicates average number of cells per cell area; Max, maximum number of cells per cell area; Min, minimum number of cells per cell area; Num, number of areas analyzed; CD, cell density per square millimeter; SD, standard deviation of the cell mean area; CV, coefficient of variation; and 6A, percentage of cells that are hexagonal.

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Figure 2. Findings in case 2. A, Cosmetic iris implant. B, Anterior segment optical coherence tomographic image demonstrating the cosmetic iris implant's close approximation to the patient's anatomical angle as well as in direct contact with the anterior surface of the iris.

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Figure 3. Microscopy findings. A, Light microscopy photomicrograph of the explanted device (original magnification ×5). B, Scanning electron microscopy photomicrograph of the anterior surface of the explant with irregular surfaces in the area of color pigmentation (original magnification ×500). C, Scanning electron microscopy photomicrograph of the posterior surface of the explant demonstrating a rough surface (original magnification ×1000). D, Light microscopy photomicrograph demonstrating irregular edge characteristics of the explant (original magnification ×100).

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