Goniosynechialysis combined with cataract extraction for iridoschisis

RATIONALE Iridoschisis is a rare eye disease. In this case report, we described the examination and diagnosis of a case of iridoschisis accompanied by secondary glaucoma. We also observed the effects of treating the patient with a combination of goniosynechialysis and cataract removal. PATIENT CONCERN A 67-year-old female patient presented with decreased vision in both eyes. An eye examination indicated that visual acuities (VAs) were 20/100 and light perception in the right and left eyes, respectively. Both eyes exhibited shallow anterior chambers and narrow angles. The lower portion of the iris was loosened, and cable-like tissue was visible. The intraocular pressures in the right and left eyes were 22 mmHg and 58 mmHg, respectively. At the time of presentation, no medication was being used. DIAGNOSES The patient was diagnosed with iridoschisis [oculus sinister (OU), indicates left eye], secondary glaucoma (OU), senile cataract (OU), and pterygium (oculus uterque, indicates both eyes). INTERVENTION After relevant examinations were conducted, goniosynechialysis and phacoemulsification with intraocular lens implantation were performed on the right eye under local anesthesia. OUTCOMES Two days after surgery, the right eye had VA of 20/40 and a transparent cornea. The anterior chamber was deeper, and intraocular pressure had decreased to 16 mmHg. Three months after surgery, the patient exhibited improved VA in the right eye and a lower IOP of 11 mmHg. LESSONS Relative to other approaches, goniosynechialysis combined with cataract removal is a better treatment option for iridoschisis complicated with closed-angle glaucoma triggered by peripheral anterior synechiae.