Priya Narang, MS, focuses her blog on complex cataract surgery cases, new techniques and innovations, along with unique case reports.

BLOG: Twofold technique for iridodialysis

Various techniques have been described in peer-review literature for the repair of iridodialysis. The twofold technique combines non-appositional as well as single-pass four-throw pupilloplasty and works effectively in all cases of iridodialysis with varied degree of severity.

Clinically, depending upon the amount of iris disinsertion and the variation in the application of the twofold technique, we have classified iridodialysis into three types: massive (> 120°), moderate (45° to 120°) and minimal (< 45°).

The twofold technique has all of the advantages of the non-appositional as well as single-pass four-throw (SFT) technique. Performing a non-appositional has the advantage of not damaging the trabecular meshwork, as it does not bunch up the iris tissue on the anterior chamber angle. Thus, it avoids the possibility of developing a secondary angle closure because with the non-appositional technique the iris tissue does not cover up the angle. SFT has the presumed advantage of inducing less inflammation and lesser pigment dispersion, as only a single pass is needed and averts unnecessary intervention in the anterior chamber.

The video displays the twofold technique that facilitates iridodialysis repair and also allows the correction of corectopia, thereby preventing glare and photophobia. It also showcases the mistake of engaging the corneal tissue into the needle, which prevents sliding of the knot into the anterior chamber.