Pupil reconstruction is often essential to overcome glare in cases of eccentric pupil, and pupilloplasty is often performed to overcome pupil eccentricity.
Traumatic cases with dilated pupil due to sphincter damage or a maldevelopment of iris tissue may lead to either partial or complete coloboma formation, which is often the indication for performing pupilloplasty. Several surgical techniques have been described to achieve a perfect round pupil.
The video showcases a modified Siepser’s slipknot technique to achieve a round pupil. Following reapproximation of the central sphincter leaflets, the pupil constricts in a normal circumferential manner and no longer constricts partially. A long straight needle attached to a 10-0 or a 9-0 polypropylene suture is used.
The video also showcases lifting of the bag-IOL complex from the posterior segment, followed by its explantation, and glued IOL surgery for secondary IOL fixation.