Achieving patent peripheral iridectomy: '23G vitrector: sectoral pupil flutter technique'

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.