Modified Intrascleral Suture Technique for Repairing Iridodialysis Combined with Phacoemulsification Cataract Surgery

Area of Science:

• Ophthalmology
• Surgical Techniques
• Ophthalmic Surgery

Background:

• Iridodialysis, often occurring with cataractous changes, requires surgical repair.
• Traditional repair methods can be invasive and time-consuming.
• Phacoemulsification cataract surgery is a common procedure for visual impairment.

Purpose of the Study:

• To introduce and evaluate the efficacy of a modified intrascleral suture technique (MIST) for iridodialysis repair.
• To compare MIST with a modified sewing-machine technique (MSMT) in combined iridodialysis and cataract surgery.

Main Methods:

• Retrospective analysis of patients undergoing iridodialysis repair and cataract surgery between 2018-2023.
• Twelve eyes underwent MIST, and eleven underwent MSMT, both utilizing a closed-chamber sewing-machine principle.
• MIST involved intrascleral suturing with a 10-0 polypropylene suture and specialized needles, guided by a syringe tip.

Main Results:

• Successful iridodialysis repair in all patients.
• MIST group had significantly shorter median procedure time (25 min) compared to MSMT (34 min; p < 0.0001).
• Postoperative visual acuity was comparable at day 1, with a trend towards better median BCVA in the MIST group (0.1 logMAR vs 0.4 logMAR). Complication rates were similar.

Conclusions:

• MIST is a minimally invasive technique for iridodialysis repair, avoiding conjunctival or scleral dissection.
• The technique significantly reduces operative time while maintaining surgical efficacy and safety.
• MIST presents a valuable option for combined iridodialysis and cataract surgery.