Abstract
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.
This is a preview of subscription content, log in via an institution to check access.
References
Finger PT (2006) Small incision surgical iridotomy and iridectomy. Graefes Arch Clin Exp Ophthalmol 244:399–400
Ghanem VC, Ghanem EA, Ghanem RC (2003) Iridectomy of the anterior iris stroma using the vitreocutter during phacoemulsification in patients with iridoschisis. J Cataract Refract Surg 29:2057–2059
Agarwal T, Jhanji V, Dutta P, Tandon R, Sharma N, Titiyal JS, Vajpayee RB (2007) Automated vitrector-assisted optical iridectomy: customized iridectomy. J Cataract Refract Surg 33:959–961
Finger PT, Latkany P, Kurli M, Iacob C (2005) The finger iridectomy technique: small incision biopsy of anterior segment tumours. Br J Ophthalmol 89:946–949
Sharma A, Sii F, Shah P, Kirkby GR (2006) Vitrectomy-phacoemulsification-vitrectomy for the management of aqueous misdirection syndromes in phakic eyes. Ophthalmology 113:1968–1973
Shimada H, Nakashizuka H, Hattori T, Mori R, Mizutani Y, Yuzawa M (2007) 25-Gauge peripheral iridectomy during vitrectomy. Eur J Ophthalmol 17:857–859
Day A, Angunawela RI, Allan BD (2008) Blow-back technique for confirmation of peripheral iridectomy patency. J Cataract Refract Surg 34:1832–1833
Hoffer KJ (2001) Pigment vacuum iridectomy for phakic refractive lens implantation. J Cataract Refract Surg 27:1166–1168
Conflict of interest
The authors have no financial or proprietary interest in a product, method, or material described herein.
Author information
Authors and Affiliations
Corresponding author
Electronic supplementary material
Below is the link to the electronic supplementary material.
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)
Rights and permissions
About this article
Cite this article
Khokhar, S., Gupta, S., Kumar, G. et al. Achieving patent peripheral iridectomy: ‘23G vitrector: sectoral pupil flutter technique’. Int Ophthalmol 33, 567–570 (2013). https://doi.org/10.1007/s10792-012-9693-3
Received:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s10792-012-9693-3