{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,29]],"date-time":"2026-06-29T05:47:42Z","timestamp":1782712062514,"version":"3.54.5"},"reference-count":16,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,6,29]],"date-time":"2026-06-29T00:00:00Z","timestamp":1782691200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"Youth Project of Wuxi Health Committee","award":["Q202227"],"award-info":[{"award-number":["Q202227"]}]}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Med."],"abstract":"<jats:p>Iridoschisis, a rare condition involving separation between the anterior iris stroma and deeper layers, primarily occurs in patients between 60 and 70\u202fyears of age. The disorder often produces a distinctive \u201cshredded wheat\u201d appearance from iris fibers floating in the anterior chamber, and it commonly coexists with angle-closure glaucoma and cataracts. We present two cases where combined surgical management proved effective. The first case was an 81-year-old woman with bilateral iridoschisis complicated by cataract. Following laser peripheral iridotomy (LPI), gonioscopic examination indicated continued angle closure. Combined phacoemulsification and goniosynechialysis surgery achieved normalized IOP and visual improvement through 18-month follow-up. The second patient was an 82-year-old man with bilateral iridoschisis and narrow angles. The first eye underwent standard cataract surgery. When operating on the second eye, intraoperative gonioscopy identified peripheral anterior synechiae, leading us to add goniosynechialysis. Postoperatively, both eyes showed excellent visual outcomes and stable IOP. For iridoschisis patients, the dual procedure of phacoemulsification and goniosynechialysis addresses two problems simultaneously: the cataract and the anatomical cause of angle closure. The combination thus offers a practical solution for complex iridoschisis cases.<\/jats:p>","DOI":"10.3389\/fmed.2026.1873711","type":"journal-article","created":{"date-parts":[[2026,6,29]],"date-time":"2026-06-29T05:38:49Z","timestamp":1782711529000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Case Report: Combined cataract surgery and goniosynechialysis in elderly patients with iridoschisis\u2014a report of two cases"],"prefix":"10.3389","volume":"13","author":[{"given":"Shuo","family":"Xu","sequence":"first","affiliation":[{"name":"Department of Ophthalmology, Jiangnan University Medical Center","place":["Wuxi, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yinong","family":"Zhang","sequence":"additional","affiliation":[{"name":"Department of Ophthalmology, Jiangnan University Medical Center","place":["Wuxi, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lingyan","family":"Cheng","sequence":"additional","affiliation":[{"name":"Department of Ophthalmology, Jiangnan University Medical Center","place":["Wuxi, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2026,6,29]]},"reference":[{"key":"ref1","doi-asserted-by":"publisher","first-page":"3324","DOI":"10.3390\/jcm9103324","article-title":"Iridoschisis-a systematic review. J","volume":"9","author":"Pieklarz","year":"2020","journal-title":"Clin Med"},{"key":"ref2","doi-asserted-by":"publisher","first-page":"381","DOI":"10.2147\/OPTH.S17269","article-title":"Iridoschisis: case report and review of the literature","volume":"5","author":"Gogaki","year":"2011","journal-title":"Clin Ophthalmol"},{"key":"ref3","doi-asserted-by":"publisher","first-page":"66","DOI":"10.1186\/s12886-024-03330-y","article-title":"A case of iridoschisis with partial lens dislocation in both eyes","volume":"24","author":"Niu","year":"2024","journal-title":"BMC Ophthalmol"},{"key":"ref4","first-page":"167","article-title":"Interstitial keratitis and iridoschisis in congenital syphilis","volume":"12","author":"Foss","year":"1992","journal-title":"J Clin Neuroophthalmol"},{"key":"ref5","doi-asserted-by":"publisher","first-page":"e8295","DOI":"10.1097\/MD.0000000000008295","article-title":"Goniosynechialysis combined with cataract extraction for iridoschisis: a case report","volume":"96","author":"You","year":"2017","journal-title":"Medicine (Baltimore)"},{"key":"ref6","doi-asserted-by":"publisher","first-page":"83","DOI":"10.1007\/s10792-012-9627-0","article-title":"Iridoschisis associated with nanophthalmos and bullous keratopathy","volume":"33","author":"Crosby","year":"2013","journal-title":"Int Ophthalmol"},{"key":"ref7","doi-asserted-by":"publisher","first-page":"NP15-7","DOI":"10.1177\/1120672119853105","article-title":"Massive iridoschisis after penetrating keratoplasty successfully managed with nd:yag punctures: a case report","volume":"30","author":"Petrovic","year":"2020","journal-title":"Eur J Ophthalmol"},{"key":"ref8","first-page":"214","article-title":"Detachment of the anterior half of the iris plane","volume":"68","author":"Schmitt","year":"1922","journal-title":"Klin Monatsbl Angenheilkd"},{"key":"ref9","doi-asserted-by":"publisher","first-page":"277","DOI":"10.1136\/bjo.29.6.277","article-title":"Iridoschisis with multiple rupture of stromal threads","volume":"29","author":"Loewenstein","year":"1945","journal-title":"Br J Ophthalmol"},{"key":"ref10","doi-asserted-by":"publisher","first-page":"794","DOI":"10.1016\/0002-9394(58)90990-5","article-title":"Iridoschisis; a clinical and histopathologic study","volume":"46","author":"Albers","year":"1958","journal-title":"Am J Ophthalmol"},{"key":"ref11","doi-asserted-by":"publisher","first-page":"763093","DOI":"10.1155\/2015\/763093","article-title":"Diagnosis and management of iridocorneal endothelial syndrome","volume":"2015","author":"Sacchetti","year":"2015","journal-title":"Biomed Res Int"},{"key":"ref12","doi-asserted-by":"publisher","first-page":"S36","DOI":"10.1097\/00061198-200110001-00014","article-title":"Axenfeld-rieger and iridocorneal endothelial syndromes: two spectra of disease with striking similarities and differences","volume":"10","author":"Shields","year":"2001","journal-title":"J Glaucoma"},{"key":"ref13","doi-asserted-by":"publisher","first-page":"741","DOI":"10.1016\/j.jcrs.2003.09.042","article-title":"Avoiding iris trauma from phacoemulsification in eyes with iridoschisis","volume":"30","author":"Rozenberg","year":"2004","journal-title":"J Cataract Refract Surg"},{"key":"ref14","doi-asserted-by":"publisher","first-page":"e221","DOI":"10.1016\/j.jcjo.2019.01.009","article-title":"Novel approaches to phacoemulsification in iridoschisis","volume":"54","author":"Snyder","year":"2019","journal-title":"Canad J Ophthalmol"},{"key":"ref15","doi-asserted-by":"publisher","first-page":"2057","DOI":"10.1016\/s0886-3350(03)00336-5","article-title":"Iridectomy of the anterior iris stroma using the vitreocutter during phacoemulsification in patients with iridoschisis","volume":"29","author":"Ghanem","year":"2003","journal-title":"J Cataract Refract Surg"},{"key":"ref16","first-page":"88","article-title":"Iridoschisis associated with syphilitic interstitial keratitis","volume-title":"Am J Ophthalmol","author":"Pearson","year":"1989"}],"container-title":["Frontiers in Medicine"],"original-title":[],"link":[{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fmed.2026.1873711\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,6,29]],"date-time":"2026-06-29T05:38:52Z","timestamp":1782711532000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fmed.2026.1873711\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,6,29]]},"references-count":16,"alternative-id":["10.3389\/fmed.2026.1873711"],"URL":"https:\/\/doi.org\/10.3389\/fmed.2026.1873711","relation":{},"ISSN":["2296-858X"],"issn-type":[{"value":"2296-858X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,6,29]]},"article-number":"1873711"}}