
Performing a pupilloplasty can be challenging since we are working with very delicate iris tissue, in the confines of the anterior chamber with a very fine suture material such as 10-0 polypropylene. For most cases, I tend to prefer the simplified 4-throw pupilloplasty technique but another good approach is the cerclage technique. This is also called a purse-string suture since it functions the same way. It requires multiple passes of the same 10-0 polypropylene suture going around the entire pupil margin. This video demonstrates the technique beautifully.

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