What Is an Iridectomy?

A conjunctival flap with a base of the dome as the base of about 5 mm is made above the limbal limbus. A 3 mm long arc-shaped scleral incision was made in the posterior border of the sclera with the same width of the internal and external incisions. Relax the upper rectus suture

Iridectomy

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A conjunctival flap with a base of the dome as the base of about 5 mm is made above the limbal limbus. A 3 mm long arc-shaped scleral incision was made in the posterior border of the sclera with the same width of the internal and external incisions. Relax the upper rectus suture

Chinese name

Iridectomy

Category

surgery

Cut

3mm long

Country

China

1. Preclinical angle-closure glaucoma.

2. Aphakic pupil with glaucoma.

3. Components of glaucoma extraocular drainage.

4. Prevention of pupillary block during cataract extraction to facilitate the removal of the nucleus

5. Very small iris tumor.

6. Irisitis pupils atresia.

7. Prevent pupil block during corneal transplantation.

8. Reduce the muscle strength of the iris sphincter and increase the pupil.

9. Optical iris resection.

10. The pupil moves up and the optic axis light is blocked.

11. Smaller central corneal leukoplakia.

1. Reduce pupils. Combined cataract surgery requires dilation.

2. People with high intraocular pressure should first use medicine to lower blood pressure.

3. Take glucocorticoid and indomethacin before surgery to reduce the postoperative response.

4. Anesthesia after ball anesthesia and conjunctival infiltration.

1. The eyelid opener opens the eyelid, and the superior rectus suture pulls and fixes the eyeball.

Gently press the posterior lip of the incision, let out a little aqueous humor, and wait for the iris to come out of the incision.

Clamp the highest point of the iris, and lift the iris perpendicular to the sclera by about 0.5 ~ 1mm. Use the right hand scissors to cut the iris from the scleral surface.

(3) Gently press the closed incision to make the inner incision open, loosen the iris pinched in the incision, contract the sphincter, and return the pupil to a round shape.

If the root of the iris on both sides of the incision is difficult to recover, a small amount of viscoelastic agent can be injected into the incision to squeeze the root iris to reset.

Or use an iris spatula to push the iris caught in the incision directly into the anterior chamber.

You can also directly grab the peripheral iris and pull it out to cut it out.

For corneal leukoplakia, static congenital prepolar cataract and nuclear cataract, pupil displacement. The preferred optical iris resection site is a central region in turn, and b is the iris corresponding to the transparent corneal region closest to the visual axis when the pupil is not dilated; Just below the nose.

Local sphincterectomy: The purpose is to remove iris adhesions and increase the amount of light entering the pupil. Applicable to small patches of central corneal leukoplakia, mild atrophy of iris. Use tweezers to clamp the 12-point pupillary iris through the incision.

Pull out the incision with the cut facing the superior rectus muscle, remove about 1 mm of tissue, and return the remaining iris tissue. The upper iris has a half-moon notch.

If the pupil is moved upward, the incision should be selected at 6 o'clock for the lower sphincterectomy. If the operation is difficult, the upper incision can be used for iris incision.

Median iris resection: The indications are the same as those of the sphincter resection, with a slightly larger resection range.

(3) Segmental iris resection: also known as fan-shaped resection, used for complicated glaucoma surgery, iris atrophy, and small pupil cataract surgery. In principle, the upper iris is selected, and the corneal scar is located above or at the center, or the lower nose can be selected It is not recommended to use this method to improve the vision of advanced nuclear cataract. The resection should include the entire iris tissue, including the sphincter and opener muscles. Use tweezers to grasp the iris tissue located in the center and pull out the iris until the edge of the pupil exposes the incision. Pull up vertically and cut the exposed iris root upwards with scissors to get a narrower resection range.

Scissors cut horizontally to get a wide resection range.

Elschnig iris cystectomy: also known as double incision lens capsule and iris resection. A full-thickness scleral incision of approximately 3 mm was made at 10 o'clock and 2 o'clock, and viscoelastic was injected into the anterior chamber. Pierce the iris 2A at a distance of 3 mm from the limbus with a 20-gauge needle. The blade of one side of the scissors extends under the iris, and the blades are cut once at 6 o'clock and 2 o'clock, respectively, and the length is about 5 mm. Exit the scissors 2B. Extend the iris forceps from this incision to clamp the free end of the cut iris and pull it outward to make it flat. Re-enter the scissors from 2 o'clock, one side of the blade extends into the back of the iris, the tip of the knife faces 6 o'clock, the curved surface of the scissors faces the limbus, and the free part of the iris 2C is cut to obtain a slightly curved triangular incision 2D.

Wilmer iris resection: also known as single incision iris resection. For patients who need cataract surgery. A limbal incision A was made at 1 point above, and the incision was 7mm long. After cutting through the last half of the corneal tissue with a special corneal knife, the tip of the knife penetrates the iris B from the iris surface at a distance of 3 mm from the corneal limbus. Enlarge the iris incision to 5-6mm. Extend the blade of one side of the iris scissors to the back of the iris, with the tip facing 6 o'clock and 3 mm from the corneal limbus. Cut the iris C on the two lines of 10-6 o'clock and 2-6 o'clock, respectively. Iris tissue 3A D.

1. Several different iris resection shapes can be obtained by different cutting directions. Shearing in the horizontal direction can obtain a triangular notch with a wide base, and shearing in the vertical direction can obtain a narrow triangular notch.

2. The iris is highly elastic and can still recover elastically after being pulled, so it is generally not necessary to use an instrument to extend into the incision to restore the iris, so as not to damage the lens.

3. When using pliers to stretch into the incision, it is not suitable to press the iris hard to avoid damaging the lens below.

4. When lifting the iris, pay attention to the deformed state of the pupil edge and the remaining width of the iris in the eye to prevent excessive extraction and excessive resection.

5. The iris that has shrunk or has adhesions, shearing can cause wound bleeding, and viscoelastic agents can be injected to stop bleeding. If new blood vessels have been found before surgery, it is best to use argon laser photocoagulation to close the blood vessels before surgery. For large bleeding areas, the electrocoagulation under water is used to directly coagulate the bleeding.

6. Try to avoid making a wide basal iris resection at the site of the cleft lip. If necessary, a smaller narrow peripheral cut or incision should be made.

7. Do not pull the iris excessively, so as not to damage the exposed ciliary body.

8. In the case of optical iris resection with no lens, in order to prevent vitreous block, it is best to perform anterior vitrectomy at the same time and another peripheral iris resection.

9. Monocular bandaging for one day, and corticosteroids were opened for several days.

10. If the reaction in the eye is obvious, you can dilate the pupils.

11. Continue taking corticosteroids and indomethacin.

1. The bleeding comes from the radial blood vessels of the iris, or deep scleral blood vessels inside the incision, causing anterior chamber hemorrhage. Should be taken in a semi-recumbent position to rest, if found iris neovascularization, argon laser iris photocoagulation can be used to close the blood vessels. Use a hemostatic agent.

2. Iris inflammatory post-adhesion is related to surgical trauma and individual differences. Conventional anti-inflammatory treatment, dilated pupils.

3. The iris is not completely cut through, leaving a layer of dark brown pigmented epithelium. No further surgery is required. Nd: YAG laser can be used to cut the epithelium.

4. Aphakic pupil block glaucoma, the anterior chamber becomes shallow, and the intraocular pressure increases. Anterior vitrectomy and another peripheral iridectomy are required.

5. Hemorrhage caused by bleeding or inflammatory exudation. The lighter ones are treated with conservative drugs, and more vitreous blood can be closed vitrectomy within 2 weeks.