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Cobbler's Technique for Iridodialysis Repair.

Pandav SS, Gupta PC, Singh RR, Das K, Kaushik S, Raj S, Ram J - Middle East Afr J Ophthalmol (2016 Jan-Mar)

Bottom Line: We describe a novel "Cobbler's technique" for iridodialysis repair in the right eye of a patient aged 18 years, with a traumatic iridodialysis secondary to open globe injury with an iron rod.Our technique is simple with easy surgical maneuvers, that is, effective for repairing iridodialysis.The "Cobbler's technique" allows a maximally functional and cosmetic result for iridodialysis.

View Article: PubMed Central - PubMed

Affiliation: Department of Ophthalmology, Post Graduate Institute of Medical Education and Research, Chandigarh, India.

ABSTRACT
We describe a novel "Cobbler's technique" for iridodialysis repair in the right eye of a patient aged 18 years, with a traumatic iridodialysis secondary to open globe injury with an iron rod. Our technique is simple with easy surgical maneuvers, that is, effective for repairing iridodialysis. The "Cobbler's technique" allows a maximally functional and cosmetic result for iridodialysis.

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Related in: MedlinePlus

Preoperative photograph showing a corneal scar inferiorly and a large iridodialysis from 7 O’clock to 10 O’clock position
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Figure 1: Preoperative photograph showing a corneal scar inferiorly and a large iridodialysis from 7 O’clock to 10 O’clock position

Mentions: Following peribulbar anesthesia, a fornix-based localized conjunctival peritomy (6–11 O’clock) was performed in the right eye of a patient with traumatic iridodialysis extending from 7 O’clock to 10 O’clock position in the inferotemporal quadrant [Figure 1]. Hemostasis of the scleral bed was achieved with wet field cautery. A partial thickness scleral tunnel was created 1.5 mm from the limbus along the extent of the iridodialysis. A limbal paracentesis was created with a stiletto knife at the 2 O’clock position, and intracameral pilocarpine was injected into the anterior chamber to place the iris tissue on the maximal stretch. Sodium hyaluronate 1.4% was then injected to deepen the anterior chamber. A 10-0 polypropylene suture was threaded through a 26-gauge needle. The 26-gauge needle was passed through the paracentesis and the 10 O’clock end of the scleral groove engaging the root of the iris. The free end of the prolene suture was pulled out at 10 O’clock. The needle was withdrawn into the anterior chamber and taken out at the 9.30 O’clock position engaging the root of the iris again. The prolene suture was pulled out forming a loop through which the free end of the suture was passed to lock the loop. This step was repeated multiple times until multiple loops laid over the scleral bed [Figure 2]. These loops were then tied [Figure 3] and the conjuctival peritomy was closed using 8-0 vicryl sutures. Subconjunctival gentamycin and dexamethasone were delivered. The postoperative photograph was as shown in Figures 4 and 5. The visual acuity at 3 weeks postoperatively was 6/18 with a pinhole.


Cobbler's Technique for Iridodialysis Repair.

Pandav SS, Gupta PC, Singh RR, Das K, Kaushik S, Raj S, Ram J - Middle East Afr J Ophthalmol (2016 Jan-Mar)

Preoperative photograph showing a corneal scar inferiorly and a large iridodialysis from 7 O’clock to 10 O’clock position
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4759894&req=5

Figure 1: Preoperative photograph showing a corneal scar inferiorly and a large iridodialysis from 7 O’clock to 10 O’clock position
Mentions: Following peribulbar anesthesia, a fornix-based localized conjunctival peritomy (6–11 O’clock) was performed in the right eye of a patient with traumatic iridodialysis extending from 7 O’clock to 10 O’clock position in the inferotemporal quadrant [Figure 1]. Hemostasis of the scleral bed was achieved with wet field cautery. A partial thickness scleral tunnel was created 1.5 mm from the limbus along the extent of the iridodialysis. A limbal paracentesis was created with a stiletto knife at the 2 O’clock position, and intracameral pilocarpine was injected into the anterior chamber to place the iris tissue on the maximal stretch. Sodium hyaluronate 1.4% was then injected to deepen the anterior chamber. A 10-0 polypropylene suture was threaded through a 26-gauge needle. The 26-gauge needle was passed through the paracentesis and the 10 O’clock end of the scleral groove engaging the root of the iris. The free end of the prolene suture was pulled out at 10 O’clock. The needle was withdrawn into the anterior chamber and taken out at the 9.30 O’clock position engaging the root of the iris again. The prolene suture was pulled out forming a loop through which the free end of the suture was passed to lock the loop. This step was repeated multiple times until multiple loops laid over the scleral bed [Figure 2]. These loops were then tied [Figure 3] and the conjuctival peritomy was closed using 8-0 vicryl sutures. Subconjunctival gentamycin and dexamethasone were delivered. The postoperative photograph was as shown in Figures 4 and 5. The visual acuity at 3 weeks postoperatively was 6/18 with a pinhole.

Bottom Line: We describe a novel "Cobbler's technique" for iridodialysis repair in the right eye of a patient aged 18 years, with a traumatic iridodialysis secondary to open globe injury with an iron rod.Our technique is simple with easy surgical maneuvers, that is, effective for repairing iridodialysis.The "Cobbler's technique" allows a maximally functional and cosmetic result for iridodialysis.

View Article: PubMed Central - PubMed

Affiliation: Department of Ophthalmology, Post Graduate Institute of Medical Education and Research, Chandigarh, India.

ABSTRACT
We describe a novel "Cobbler's technique" for iridodialysis repair in the right eye of a patient aged 18 years, with a traumatic iridodialysis secondary to open globe injury with an iron rod. Our technique is simple with easy surgical maneuvers, that is, effective for repairing iridodialysis. The "Cobbler's technique" allows a maximally functional and cosmetic result for iridodialysis.

Show MeSH
Related in: MedlinePlus