Transillumination defects following in-the-bag single-piece intraocular lens implantation and trabeculectomy with mini-shunt

An 80-year-old woman of mixed ethnicity developed significant iris transillumination defects following phacoemulsification with in-the-bag implantation of a single-piece hydrophobic acrylic intraocular lens (IOL) and trabeculectomy with insertion of an Express mini-shunt. With the exception of modest anterior chamber shallowing in the first few weeks postoperatively, the surgery and postoperative course were uneventful. The observed iris defects are thought to have been caused by contact between the IOL-capsule complex and the posterior iris during shallowing of the anterior chamber. No other cases in the peer-reviewed literature have identified iris defects secondary to implantation of a single-piece monofocal hydrophobic acrylic IOL when the optic and haptics remained entirely within the capsular bag.