A prospective study of clinical profile of iridocorneal endothelial syndrome in a tertiary care hospital

Abstract

Introduction: Irido-Corneal Endothelial (ICE) syndrome is an uncommon clinical entity which includes corneal endothelial damage, obstruction of anterior chamber angle, iris atrophy and polycoria.1 these proliferative and structural abnormalities are the hallmark of this disease. Corneal decompensation and glaucoma are the commonest causes of vision loss in patients with ICE syndrome.Materials and Methods: All patients diagnosed with ICE syndrome as mentioned in our inclusion criteria diagnosed between the October 2019-October 2020. A total of 50 patients were included in our study after ruling out exclusion criteria and the data was retrospectively analysed. Data pertaining to age, gender, clinical spectrum of disease, laterality, Visual acuity, corneal and iris findings, anterior chamber (AC) depth, gonioscopic findings, reaction in AC, association with glaucoma, medical and surgical management was collected, number of AGMs used, duration of follow up collected.Results: We studied 51 eyes of 50 patients with age range of 7-65 years with median age at presentation was 40.72 years. 28 (56%) were female and 22 (44%) were male. ICE syndrome was unilateral in 49 (98%), of which right was involved in 25 (50%) and left was involved in 24 (48%). Mean IOP of involved eye was 23.70± 11.7 mm of Hg. PIA and CS variant of ICE syndrome were equal in frequency of 20 (40%). CRS was found as least variant of ICE syndrome and was 10 (20%) patients. Out of 51 eyes of study group we had 43 (84.3%) eyes were phakic and 7 (13.7%) eyes were pseudophakic. There was no aphakic eye in our study group patients. Conclusion: In our study, ICE syndrome was unilateral, and middle-aged females were more commonly affected. Glaucoma is strongly associated with ICE syndrome. Surgical management is required in majority of the affected patients. ICE patients may require more than 1surgery for IOP control. They are commonly associated with corneal complications which may require penetrating keratoplasty.