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Avoiding iris trauma from phacoemulsification in eyes with iridoschisis.
Israel Rozenberg1, Fabíola P Seabra
1Instituto de Olhos Leblon, Av. Ataulfo de Paiva 1079, Suite 606, 22440-031 Rio de Janeiro-RJ, Brazil.
Journal of Cataract and Refractive Surgery
|April 20, 2004
Summary
Phacoemulsification surgery in eyes with iridoschisis is challenging due to free-floating iris fibrils. A novel technique uses ophthalmic viscosurgical devices (OVDs) to stabilize iris fibrils, enabling safer cataract removal.
Area of Science:
- Ophthalmology
- Surgical Techniques
Background:
- Iridoschisis is a rare anterior segment anomaly often co-occurring with age-related cataracts.
- Phacoemulsification in iridoschisis presents challenges due to detached iris fibrils obstructing surgical instruments.
Observation:
- Free-floating iris fibrils in the anterior chamber are attracted to the phaco tip and irrigation/aspiration ports.
- A modified surgical technique is required to manage these delicate iris structures during cataract surgery.
Findings:
- Injecting two ophthalmic viscosurgical devices (OVDs) into the inferior anterior chamber stabilizes iris fibrils.
- Creating an elliptical capsulorhexis limited to the superior pupil enhances anterior chamber stability.
- Performing phacoemulsification primarily under the anterior capsule minimizes iris trauma.
Implications:
- This technique facilitates safer and more effective phacoemulsification in eyes with iridoschisis.
- It reduces the risk of mechanical trauma to the iris during cataract surgery.
- The described method offers a valuable approach for ophthalmic surgeons managing complex cataract cases.