Further Inpatient Care
- After surgery, patients may be monitored on either an inpatient basis or an outpatient basis. Admitting patients for at least 1 day after surgery is recommended.
Further Outpatient Care
- Corneal sutures may be removed when they become loose or in stages after 4-6 weeks.
- Long-term follow-up care is necessary to monitor intraocular pressure and cataract formation. In patients who are medically treated, the eye should be carefully examined for iritis and cystoid macular edema. The fellow eye should be carefully examined for signs of sympathetic ophthalmia.
Inpatient & Outpatient Medications
- Postoperatively, patients are prescribed antibiotics, steroid drops, and cycloplegics for 3-6 weeks.
Deterrence/Prevention
- The patient should be instructed to wear protective eyeglasses that cover the eye from the front and the sides while working with mechanical devices and tools or during contact sports. (The author recommends avoiding contact sports.) The protective eyeglasses should be made of polycarbonate, a shatterproof material.
Complications
- Several complications can occur because of an iris prolapse, as follows:
- The prolapsed iris may act as a scaffold and introduce intraocular infection, such as endophthalmitis.
- If left untreated, the prolapsed iris becomes covered by epithelial and fibrous tissue, which may then grow into the eye.
- Although rare, sympathetic ophthalmia can occur.
- Iritis and cystoid macular edema can result from traction on the iris tissue.
- Secondary glaucoma may occur as result of iritis, synechiae, or epithelial downgrowth.
Prognosis
- Prognosis depends on several factors. The smaller the prolapse, the better the prognosis.
- Patients with other injuries and intraocular foreign bodies are likely to have a poor prognosis.
- The presence of infection carries a poor prognosis.
- Epithelial downgrowth and fibrous ingrowth are difficult to treat and have a poor prognosis.
Patient Education
- For excellent patient education resources, visit eMedicine's Eye and Vision Center. Also, see eMedicine's patient education article Eye Injuries.
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