Abstract
P 047
Laser treatment of irisvarix with recurrent hemorrhage
Berit Meinhardt, Karsten Kasper, Thomas Klink
Universitäts-Augenklinik Würzburg
Objective
Irisvarix is a rare disease pattern. Its clinical appearance is defined as a neoplasm of the irisstroma with brownish to sanguinary black coloration. In the course of the disease there are often bleedings from the varix with development of hyphema, which could lead to a secondary glaucoma.
Results
Case report: We report on a 68-year-old patient with an irisvarix on his right eye, which was diagnosed in August 2007. The ultrasound biomicroscopy (UBM) displayed a cystic formation with a size of 3.0 x 2.9 mm and a prominence of 1.7mm in the upper temporal quadrant. Clinical findings displayed a cystic aerated stroma of the iris with translucent pigment epithelium. The first bleeding into the varixnode was in April 2008. In the course there were recurrent bleedings with hyphema, finally with increase of the intraocular pressure (IOP). Thereupon a circumferential argon laser coagulation (energy: 260 - 340mW, length of exposition: 0.2 sec.) was performed. After an interval of four weeks there was a recurrent bleeding of the varix with hyphema and elevated IOP. Subsequent another laser treatment with a diode laser was conducted circumferentially and on the lesion itself (energy: 400mW, length of exposition: 0.2 sec., size of laser spot: 300µm). The last follow-up showed a completely thrombosed varix.
Conclusions
Discussion: There are just a few publications of case reports of iris varix. In the majority of cases sector iridectomy was the treatment of choice. To our knowledge the present laser surgery of an irisvarix was not published yet. In the described case we considered a therapy with a thermic laser (diode laser) to reduce the risk of complications like diplopia and cataract formation after sector iridectomy.
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