ESCRS - PO766 - Hosny-Modified Single Pass 4-Throw Pupilloplasty Mohamed Hosny Abdelrahman1, David Strickland2, Jack Parker Md Phd3

Hosny-Modified Single Pass 4-Throw Pupilloplasty Mohamed Hosny Abdelrahman1, David Strickland2, Jack Parker Md Phd3

Published 2025 - 43rd Congress of the ESCRS

Reference: PO766 | Type: Free paper | DOI: 10.82333/z79g-t794

Authors: Demetrios Pirounides 1 , Georgios Balanikas 1 , Panteleimon Ioannidis* 1 , Fountouki Angeliki 1 , Aikaterini Tsiliggiri 2

1Ophthalmology,AHEPA University Hospital,Thessaloniki,Greece, 2Ophthalmology,Papageorgiou University Hospital,Thessaloniki,Greece

Purpose

Purpose

Single-Pass Four-Throw Pupilloplasty (SPFT) was introduced in 2017 by Narang and Agarwal as a novel iris repair technique. It involves passing a suture once through the eye, securing it externally with a 4-loop knot, and tightening it intraocularly. The technique simplifies iris reconstruction compared to traditional methods. However, two notable challenges exist: the use of a 26G needle can create unintended iris perforations, affecting both function and cosmesis, and the docking maneuver between the 10-0 Prolene suture and the needle can be cumbersome. This study presents a modified approach to SPFT that eliminates these drawbacks, improving procedural efficiency and outcomes.

 

Setting

 Here, we describe a simple modification to the SPFT technique that eliminates both difficulties. 

Methods

Methods:

A comparative surgical trial was conducted at Parker Cornea, evaluating Hosny’s Technique against the conventional SFT method. Key innovations include a one-handed surgical approach, elimination of the 26G guiding needle, and the use of a curved Prolene needle for more controlled iris passage. Postoperative visual acuity, surgical ease, and complication rates were analyzed in patients undergoing PPP for post-RK astigmatism

Results

Results:

Among seven eyes treated with Hosny’s Technique, uncorrected distance visual acuity (UDVA) of 20/20 was achieved in 57% of cases, with all patients experiencing reduced glare and improved functional vision. Compared to the SFT method, Hosny’s Technique demonstrated shorter operative time, fewer iris perforations, and superior postoperative cosmesis.

Conclusions

Conclusion:
Hosny’s Technique offers a simplified, minimally invasive alternative to traditional pupilloplasty methods, improving both surgical efficiency and patient outcomes. Its adaptation in complex anterior segment cases, particularly in post-RK patients, presents a promising advancement in corneal and refractive surgery. Further studies are warranted to assess its long-term efficacy across diverse patient populations.