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Peripheral Iris Cerclage in Angle Closure Glaucoma: A Retrospective Pilot Study
Ticiana De Francesco1,2,3, Edward Tran4,5, Fernanda Nicolela Susanna6
1Department of Opthalmology and Visual Sciences, John Moran Eye Center, University of Utah, Salt Lake City, UT, USA.
Clinical Ophthalmology (Auckland, N.Z.)
|August 14, 2026
Summary
Peripheral iris cerclage (PIC) effectively widens the angle and reduces intraocular pressure in angle-closure glaucoma (ACG) patients. This novel surgical technique shows promise for managing ACG with favorable outcomes.
Area of Science:
- Ophthalmology
- Glaucoma Surgery
- Surgical Innovation
Background:
- Angle-closure glaucoma (ACG) poses a significant risk for vision loss.
- Traditional treatments may not suffice for all ACG patients, necessitating novel approaches.
- Flaccid iris tone and high iris insertion are challenging factors in ACG management.
Purpose of the Study:
- To introduce and evaluate a new surgical method: peripheral iris cerclage (PIC).
- To assess the clinical and anatomical results of PIC in patients with ACG.
- To determine the efficacy of PIC in managing eyes at high risk of recurrent angle closure.
Main Methods:
- A retrospective pilot study involving 8 eyes (7 patients) with ACG.
- Peripheral iris cerclage (PIC) was performed, often with adjunctive procedures.
- Outcomes measured included Shaffer angle grade, peripheral anterior synechiae (PAS), intraocular pressure (IOP), and medication use.
Main Results:
- Significant increase in Shaffer angle grade (0 to 3) and decrease in PAS (75% eyes with no PAS).
- Median IOP reduced from 33.5 mmHg to 12.0 mmHg; medication classes decreased from 4 to 2.
- Qualified success achieved in 87.5% of eyes, with no intraoperative complications.
Conclusions:
- Peripheral iris cerclage (PIC) leads to sustained angle widening and reduced IOP in ACG.
- PIC is a promising adjunct for ACG management, especially in eyes with specific iris characteristics.
- This technique offers favorable anatomical and clinical outcomes for complex glaucoma cases.
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