Achieving patent peripheral iridectomy: ‘23G vitrector: sectoral pupil flutter technique’
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A novel technique for creation of a peripheral iridectomy is presented which in our series of cases yielded a 100 % success rate. Constriction of the pupil is achieved by intracameral carbachol instillation to achieve a taut peripheral iris. A 23G vitrector on aspiration mode is first used to engage the peripheral iris with high vacuum. On pressing the foot switch to position two (in suction only mode, the peripheral iris is engaged and on pressing the foot switch to position three (in the cut mode) full thickness iridectomy is achieved. As a full thickness iris defect is made, the iris tissue flutters and the corresponding pupillary margin peaks towards the iris base due to aqueous currents through the newly created conduit; indicating that a patent iridectomy has been achieved.
KeywordsPeripheral iridectomy Pupil flutter 23G vitrector
Conflict of interest
The authors have no financial or proprietary interest in a product, method, or material described herein.
Video: The video of the entire procedure is shown. Pupil is constricted, corneal incision is secured with suture and a 23G vitreo-cutter is introduced through the main port facing downwards. The moment the iris flutter is noticed in the corresponding segment, it is a sign that the pass is thorough. Once the vitrector is removed from the port, retro-illumination glow is visible from the site of peripheral iridectomy (MPG 7.70 MB)