Iris Repair Techniques – A Literature Review And A Video Review

Iris defects can arise from trauma, post-acute angle-closure glaucoma, uveitis, infections, be congenital, or others. Several techniques exist for iris repair, each adapted for the type of iris defect. We intended to compare our techniques to the literature review.

We performed a monocentric retrospective study in our tertiary hospital. 

We conducted a literature review of the existing different iris repair techniques. We also performed a retrospective study with review of the surgical videos in which there was iris repair, and identified the technique used by the surgeon, and compared with the previously published techniques. We built an algorithm of iris repair based on these videos.

In our video review, the surgeon used simple pupilloplasty in sectorial iris defects with sufficient tissue (with interrupted sutures using intraocular technique, McAhmed technique, or Siepser technique), or iris prostheses (namely from HumanOptics and Morcher) with insufficient tissue. In global iris defects, iris cerclage was used (either partial or complete) if there was sufficient tissue and iris prostheses otherwise. Iridodialysis required a different approach. Other procedures were needed in the majority of cases, namely associated glaucoma surgeries. The techniques corresponded to the literature, adapted to each patient’s needs. There were no surgical complications in our case series, and all patients had less photophobia.

According to the type of defect and to the amount of iris tissue present, different techniques can be used. Usually a complex surgery with treatment of other associated ophthalmic pathologies is needed. A systematic approach with an algorithm can help.