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

To introduce a modified intrascleral suture technique (MIST) for repairing iridodialysis combined with phacoemulsification cataract surgery and evaluate its efficacy.

We retrospectively analyzed the clinical characteristics and surgical outcomes of patients undergoing iridodialysis repair and cataract surgery (2018-2023). Twelve eyes received MIST, and eleven received the modified sewing-machine technique (MSMT). Both techniques utilized the closed-chamber sewing-machine principle of suture loop formation. MIST utilized a 10-0 polypropylene suture with long straight and short curved needles, guided by a 26-gauge syringe tip for intrascleral suturing. MSMT involved creating a partial-thickness scleral tunnel, through which a prethreaded needle with 10-0 polypropylene suture was passed for fixation.

Iridodialysis was successfully repaired in all patients. The median procedure time was significantly shorter in the MIST group (25 min, IQR: 24.0-27.5) than in the MSMT group (34 min, IQR: 29.0-35.0; p < 0.0001). Although postoperative day 1 best-corrected visual acuity (BCVA) did not differ significantly between groups (p = 0.08), the median BCVA was better in the MIST group (0.1 logMAR, IQR: 0.0-0.4) than the MSMT group (0.4 logMAR, IQR: 0.1-0.6). Complication rates were comparable between groups.

The MIST technique provides a minimally invasive alternative for iridodialysis repair by eliminating the need for conjunctival or scleral dissection. This approach significantly reduces operative time while maintaining surgical efficacy and safety, making it a valuable option for combined iridodialysis and cataract surgery.