MS. RUKHSHANDA SHABBIR

DR.APARNA RAO

Abstract

Purpose: To report a case of iridocorneoendothelial syndrome (ICE) syndrome with unusual course after glaucoma filtering surgery.

Methods: A 38-year male presented with blurrred vision in the left eye for 1 month. Brown iris nodules in the temporal quadrant with peaked pupil, synechial angle closure, raised intraocular pressure (IOP) of 44 mmHg, and pleomorphism/polymegathism on specular microscopy,suggested a diagnosis of Cogan-Reese syndrome. Progressive synechiae and uncontrolled IOP mandated filtering surgery.

Result: He underwent trabeculectomy with MMC followed by Ahmed glaucoma valve implant (FP7) and sectoral iridectomy. Though the IOP was controlled, he developed viral anterior uveitis that required antivirals. He developed corneal decompensation by recurrent viral reactivation (5 episodes) under cover of Acyclovir with controlled IOP over the next 11 months.

Conclusion: Viral etiology and its sequelae in ICE syndrome should be kept in mind during management of these cases.