Supplementary Material for: Two-Step ICE Syndrome Management: Endocapsular IOL And Artificial Iris Followed By DSAEK

A 54-year-old female presented with complaints of glare and progressive visual loss OS with a corrected distance visual acuity (CDVA) OS of 20/100. The patient had grade 1 corneal edema with a “beaten bronze” appearance on specularly reflected light, pseudopolycoria and a nuclear sclerotic cataract. The diagnosis of nuclear cataract and Progressive Iris Atrophy Iridocorneal Endothelial (ICE) syndrome was made, and the patient underwent uneventful phacoemulsification with capsular bag placement of an Acrysoft SA60AT intraocular lens (IOL) combined with pseudopolycoria repair using an endocapsular Model A REPER artificial iris. Six months later, the patient was submitted to a DSAEK procedure and six months after that the CDVA was 20/32 with no corneal edema and normal intraocular pressure. This two-step surgical approach, combining phacoemulsification and endocapsular foldable iris prosthesis placement followed by DSAEK, may be considered a promising option to successfully treat Progressive Iris Atrophy ICE syndrome patients.