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Updated: Jun 28, 2025
Iris Fixation via External Pentagram Suturing
Published on: May 5, 2022
Late iris cerclage suture cheese-wiring
Malik S Ladki1, Michael E Snyder
1From the University of Texas Medical Branch at Galveston, School of Medicine, Galveston, Texas (Ladki); Cincinnati Eye Institute, Cincinnati, Ohio (Ladki, Snyder); University of Cincinnati School of Medicine, Cincinnati, Ohio (Snyder).
Purpose:
To describe a case series of cerclage failures due to cheese-wiring; iris repair can develop late cheese-wiring of cerclage sutures with resultant loss of benefits.
Setting:
Cincinnati Eye Institute, Cincinnati, Ohio.
Design:
Retrospective single-surgeon case series.
Methods:
A retrospective chart review sought patients who underwent iris cerclage at the Cincinnati Eye Institute who later developed suture cheese-wiring. The patient symptoms, demographics, cerclage size, suture type, knot type, iris status, and suture status at final follow-up were ascertained.
Results:
6 cases of cerclage suture cheese-wiring with loss of the original surgical benefit were identified. 10-0 polypropylene suture and a 3-1-1 knot were used in each case. The suture remained intact with an intact knot and suture loop in all cases.
Conclusions:
Cheese-wiring with return of mydriasis is a potential long-term outcome of iris cerclage suture placement, with return of preoperative symptoms. Awareness of this potential eventuality provides physicians and patients a broader perspective when selecting between cerclage suture, iris prosthesis placement, or other surgical and nonsurgical options.
