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Technique for surgical iridotomy in eyes with anterior chamber intraocular lenses and aphakic eyes

Poster Details

First Author: A.Sharma UK

Co Author(s):    G. Nithyanandrajah   Y. Athanasiadis   B. Sharma   D. Bishop   M. Trivedy  

Abstract Details


To create a safer more controlled peripheral iridotomy


Moorfields at Bedford Hospital


After implantation of an anterior chamber lens and full effect of intracameral Miochol, the anterior chamber is reformed with viscoelastic. A 20 gauge Edgeahead Stilleto/MVR knife (Beaver - Visitec international Ltd) is tunnelled through the cornea in the same orientation as for a paracentesis (figure 1). Upon entering the anterior chamber the MVR blade is pointed posteriorly and pushed partially or completely through the iris (figure 2). The blade is kept perpendicular to the iris fibres. This action cuts the iris fibres and creates a small peripheral iridotomy. This could be considered as an analogue to the photo-disruption effect of YAG – laser which cuts the iris tissues to create an iridotomy in cases of occludable angles. Taking into account that the recommended size for these iridotomies so that not to close spontaneously is 150-200?m, clinical judgement should be used to achieve a similar size iridotomy with the manual method we describe using the MVR blade.


Patent iridotomy see figure 3


The above technique is a simple, controlled and self sealing technique particularly useful in unplanned cases such as posterior capsule rupture with vitreous loss during cataract surgery requiring an anterior chamber implant and a peripheral iridectomy. The corneal tunnel can be made from a central to peripheral corneal direction so the blade can reach a more peripheral part of the iris. An MVR with a less tapered point could be used as the tunnel would be shorter.

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