Iridodialysis Repair Using The Degirmenci Technique: A Flanged Transscleral Loop-Guided Method

Iridodialysis repair remains surgically challenging, requiring stable iris reattachment while preserving pupil configuration and minimizing suture-related complications. Although various ab interno and ab externo techniques, including transscleral suturing and flanged fixation, have been described, limitations such as conjunctival erosion, suture exposure, and limited control of iris-scleral apposition persist. The Degirmenci Technique introduces a loop-guided transscleral fixation method designed to allow controlled iris repositioning while avoiding externalized knots. This study describes the technique and reports clinical outcomes in four consecutive cases.

Tertiary referral university hospital, Department of Ophthalmology.

Four patients with traumatic iridodialysis underwent repair using a loop-guided transscleral 9-0 polypropylene fixation. Following conjunctival peritomy, the suture was introduced into the anterior chamber from the opposite quadrant. A 26-gauge needle inserted 2 mm posterior to the limbus at the dialysis site was used to guide suture externalization. The same scleral entry was used to engage the peripheral iris and achieve controlled iris-scleral approximation by passing the suture through its external loop. Fixation points were placed at approximately 2 mm intervals. The suture was then flanged and buried intrastromally.

Successful anatomical repair was achieved in all four cases. A clinically acceptable, round pupil was obtained in each patient. Follow-up ranged from 4 to 11 months. No intraoperative or postoperative complications were observed. Importantly, no cases of conjunctival erosion, suture exposure, chronic irritation, hypotony, or secondary glaucoma occurred.

The Degirmenci Technique provides effective anatomical restoration and favorable functional outcomes in iridodialysis repair. Intrastromal burial of the flanged suture tip may reduce the risk of conjunctival erosion and enhance long-term safety. Beyond iridodialysis, this method may be adaptable to other anterior segment conditions requiring peripheral fixation, such as cyclodialysis cleft repair. Larger prospective studies are warranted to further validate its safety and broader applicability.