Repair of Iridodialysis with Sewing Machine Technique and Pupilloplasty Using Four-Throw Method: A Low Invasive Approach to Iris Reconstruction

Abstract

Iris damage from trauma, congenital anomalies, or iatrogenic injuries can result in iridodialysis and pupillary defects, leading to visual impairment and aesthetic issues. This chapter discusses two surgical techniques for iris reconstruction: the Sewing Machine Technique for iridodialysis repair and the single-pass four-throw (SFT) method for pupilloplasty. The Sewing Machine Technique allows for quick suturing of large iridodialysis defects with minimal tissue manipulation, but it may not restore the pupil’s shape or function. Pupilloplasty, using the SFT method, corrects pupillary distortion by creating a self-retaining knot with minimal anterior chamber manipulation. Both techniques are often performed alongside cataract surgery, with the use of iris hooks or viscoelastic agents for better surgical access and to prevent iris prolapse. The chapter provides a detailed step-by-step description of both procedures, emphasising their effectiveness in restoring both iris function and aesthetics in patients with iris defects. These low-invasive approaches offer reliable solutions for managing complex iris injuries.