![]() ![]() Repair strategies are largely guided by the extent of iris lost or damaged and the health of the remaining tissue. REPAIRING PREEXISTING IRIS PATHOLOGY DURING CATARACT SURGERY “You are the apple of my eye”: this saying is a reminder not to underestimate the value of the pupil’s appearance.Īs for any surgery, the ophthalmologist must help set reasonable expectations for the patient. The surgical objective is to successfully address the patient’s complaints or condition in addition to the previous considerations (ie, preserving or reestablishing optical performance and structural integrity).Ĭosmetic considerations vary based on the individual patient and iris color. In the latter scenario, suture erosion (ie, “cheese wiring”) would be more likely to occur. A surgical injury to a healthy iris, for example, would be more amenable to suture repair than an iris that is highly atrophic from previous ischemia. Structural considerations involve the present and long-term integrity of the iris. A small pupil can also limit the ophthalmologist’s visualization of the posterior segment, thus making it difficult to monitor other disease processes. A very small pupil produces dim or “tinted” vision and approaches a diffractive-limited optical system. An exceptionally large pupil is more likely to elicit complaints of blurred vision and glare. Optical considerations take into account the importance of pupillary shape and size regulated by the iris. There are five primary considerations when repairing an iris during cataract surgery. Although challenging to achieve, restoration of the iris is one of the most rewarding moments in anterior segment surgery. Cataract surgery ceases to be conventional when the iris requires surgical repair. Sidebar: The Utility of a Vacuum-Based Pump System in Complex Cataract CasesĪbnormalities of the iris and pupil may be preexisting, or they may occur during or even after cataract surgery (see Abnormalities of the Iris). What Determines the Success of a LASIK Practice? Update on the Utilization of UBM for Cataract and IOL Applications The Role of Triamcinolone in Complex Cataract Cases Repairing the Iris During Cataract Surgery ![]() The Intumescent White Cataract and the Case of the Secret Foreign Body Toric IOL in the Setting of a Ruptured Posterior Capsule In Treating DED, Success Means Considering All Factors How Will the ACA Affect Your Practice in 2014? The Clinical Impact of Color LED Topographic Variability Analysis Improving Centration With OCT-Guided Laser CapsulotomyĬorneal Scarring After Refractive Surgery Proper Toric IOL Alignment Begins With Centration Monitored Anesthesia Care for Ophthalmic Surgery Transforming Treatment Through Drug Delivery ![]()
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