Optical iridectomy in children with corneal opacities

Optical iridectomy creates a clear entrance pupil, improving vision in patients with segmental corneal opacities. An area of clear peripheral cornea can produce retinal images compatible with good visual acuity.

The records of 22 children who underwent optical iridectomy from January 2002 to June 2004 were reviewed retrospectively. The optical iridectomy site was selected after slit-lamp examination. Visual acuity was assessed pre- and postoperatively by an age-appropriate method.

Twenty-two children with central corneal opacities underwent the procedure. Mean age was 10.4 +/- 12.6 months (range, 8-24 months). Mean follow-up period was 22.2 +/- 56.2 months (range, 8-140 months). No intraoperative or postoperative complications were observed. Visual acuity improved to near normal in 4 children (18.2%). However, 4 children (18.2%) did not show any improvement, and 1 child lost vision. Two patients (9.1%) showed no improvement in vision despite maintaining a clear line of sight.

Optical iridectomy is an alternative when penetrating keratoplasty cannot or should not be performed.