Ticiana De Francesco, MD, Jingyi Ma, BMSc, Iqbal Ike K. Ahmed, MD, FRCSC
Introduction
Iris defects and distorted pupils are commonly managed using iris suturing techniques designed to close the defect and/or restore a physiologically shaped pupil.
Re-creating an optimally sized and centered pupil can be challenging, particularly in cases involving missing iris tissue, asymmetrical iris damage, or variable tension around the pupil.
Current Treatment Options
Current surgical options include removing or cutting iris tissue using microscissors or a vitreous cutter, mechanical stretching of the iris with surgical instruments, and postoperative laser photocoagulation.
Although these techniques can be effective, they may require substantial manipulation of the iris and, in some cases, result in additional tissue trauma.
Iris Microendodiathermy Technique
Iris microendodiathermy represents a simple, minimally traumatic, titratable, and controlled technique for pupil reconstruction. The procedure minimizes excessive tissue manipulation and can create a round and cosmetically pleasing pupil.
A bipolar endodiathermy cautery probe is applied to the iris stroma to induce localized tissue contraction. This contraction gently pulls the pupil toward the meridian where the probe is applied, allowing controlled modification of pupil position and size.
Endothermal Pupilloplasty
Endothermal pupilloplasty (EDP) can be used to recenter or enlarge a small pupil. By inducing controlled contraction of the iris tissue, the technique may achieve pupil remodeling while avoiding the additional trauma associated with procedures that physically cut the iris using a vitrector or microscissors.
Referência
Journal of Cataract & Refractive Surgery. 2021;47:e80–e83. Copyright © 2021. Published by Wolters Kluwer on behalf of ASCRS and ESCRS.