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Symptomatic iris defects need repair
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KOLOA, Hawaii — Not all iris defects need to be repaired, but those that are symptomatic or may interfere with another surgical procedure need to be addressed, according to a speaker here.
“Why repair the iris? Do you really need to? No, you probably don’t. There are a lot of contact lenses you can use, and small, asymptomatic iris defects you can leave alone. [However], symptomatic iris defects, or a defect that will interfere with another surgery… needs to be repaired,” Brandon Ayres, MD, said at Hawaiian Eye.
Brandon Ayres
Iris dialysis is one defect that needs repair, Ayres said. He said he prefers to use a CIF-4 or STC-6 needle with 10-0 Prolene for the procedure and enters through a small incision. He uses a guide needle through the sclera or pocket, and to ensure success, ties the sutures after all the mattress sutures are placed.
Patients with an atonic pupil need to be addressed also, Ayres said, and in his opinion the best technique to address the defect is to use a cerclage suture. Additionally, physicians can successfully use a “pinch iridoplasty” to repair two small iris defects that need to be brought together in the eye.
“Iris repair can be very rewarding and challenging for both the physician and patient. Multiple techniques may need to be employed in any certain surgery; you’re never quite sure of what you’re going to get. In cases where iris repair is not possible, hopefully in the near future we’ll have a couple of devices that will help us with iris replacement,” he said. – by Robert Linnehan.
Reference:
Ayres B. Iris repair and replacement. Presented at: Hawaiian Eye; Jan. 14-20, 2017; Koloa, Hawaii.
Disclosure: Ayres reports he is a consultant for Alcon, Allergan, Bausch + Lomb, Shire, Micro Surgical Technology, Omeros, Rapid Pathogen Screening and TearLab, and a member of the speakers bureau for Alcon, Allergan, Bausch + Lomb and Shire.