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Iridectomy

Iridectomy
Large peripheral iridectomy deforms pupil
Other namesSurgical iridectomy
ICD-9-CM12.1
MeSHD032801

An iridectomy, also known as a surgical iridectomy or corectomy,[1] is the surgical removal of part of the iris.[2][1] These procedures are most frequently performed in the treatment of closed-angle glaucoma and iris melanoma.[1]

Comparison with Nd:YAG laser iridotomy

Ancient Hindu and modern iridectomy knives

In acute angle-closure glaucoma cases, surgical iridectomy has been superseded by Nd:YAG laser iridotomy, because the laser procedure is much safer. Opening the globe for a surgical iridectomy in a patient with high intraocular pressure greatly increases the risk of suprachoroidal hemorrhage, with potential for associated expulsive hemorrhage. Nd:YAG laser iridotomy avoids such a catastrophe by using a laser to create a hole in the iris, which facilitates flow of aqueous humor from the posterior to the anterior chamber of the eye.[3]

Current indications

Surgical iridectomy is commonly indicated and performed in the following cases:[citation needed]

  • Cataract surgery in a glaucoma patient
  • Combined procedure for cataract and glaucoma
  • Acute closed-angle glaucoma
  • Posterior capsular tears with vitreous loss
  • Implantation of anterior chamber IOL.
  • Vitreoretinal procedure involving injection of silicone oil. The location of the iridectomy in such cases is at 6 o'clock, as opposed to routine iridectomy done at 11 to 1 o'clock. This is because silicone oil is less dense than water.
  • Iris trauma

Types

  • An antiphogistic iridectomy is the surgical removal of part of the iris to reduce intraocular pressure in inflammatory conditions of the eye.[2]
  • A basal iridectomy is an iridectomy which includes the root of the iris.[2]
  • An optical iridectomy is the surgical removal of part of the iris to enlarge the existing pupil, or to form an artificial pupil, when the natural pupil is ineffectual.[2]
  • A peripheral iridectomy is the surgical removal of a portion of the iris in the region of its root, leaving the pupillary margin and sphincter pupillae muscle intact.[2] It is used in the treatment of glaucoma.[1]
  • A preliminary iridectomy, or preparatory iridectomy, is the surgical removal of part of the iris preceding cataract extraction.[2] It facilitates the removal of the cataractous lens.[1]
  • A sector iridectomy, also known as a complete iridectomy or total iridectomy, is the surgical removal of a complete radial section of the iris extending from the pupillary margin to the root of the iris.[2] A key-hole pupil is left by the removal of a wedge-shaped section of iris.[4]
  • A stenopeic iridectomy is the surgical removal of a narrow slit or a minute portion of the iris, leaving the sphincter pupillae muscle intact.[2]
  • A therapeutic iridectomy is the surgical removal of a portion of the iris for the cure or prevention of an ocular disease.[2]

See also

References

  1. ^ a b c d e Surgery Encyclopedia - "Iridectomy." Encyclopedia of Surgery: A Guide for Patients and Caregivers. Retrieved May 20, 2006.
  2. ^ a b c d e f g h i Cline D; Hofstetter HW; Griffin JR. Dictionary of Visual Science. 4th ed. Butterworth-Heinemann, Boston 1997. ISBN 0-7506-9895-0
  3. ^ Ou, Yvonne (5 July 2021). "Side Effects of Laser Iridotomy". www.brightfocus.org. University of California, San Francisco. Archived from the original on 23 February 2023. Retrieved 23 February 2023.
  4. ^ Cassin, B. and Solomon, S. Dictionary of Eye Terminology. Gainesville, Florida: Triad Publishing Company, 1990.
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