We are always looking for ways to make our surgeries more efficient and safer, and today I want to show you a brilliant surgical pearl develoed by Dr. Jonathan Tijerina, a glaucoma fellow at the Bascom Palmer Eye Institute in Miami and performed by his attending Professor Chang. This is his Needle-Assisted, Single-Step Flexible Iris Hook Insertion Technique.
As we know, managing a small pupil is one of the biggest challenges in cataract surgery. Traditional iris hook placement often involves multiple steps: making the paracentesis, inserting the hook, and then struggling to engage the iris margin while sliding the silicone stopper.
This surgical innovation simplifies this into a single, fluid motion:
- The Technique: By using a 27g or 30g (thin-walled) needle as a guide/inserter, the surgeon can deploy the flexible iris hook directly and engage the pupillary margin in one step. No paracentesis is necessary.
- The Benefit: It increases surgical efficiency and provides excellent intra-ocular stability. It’s about reducing instrument travel and making the expansion of the pupil more predictable, efficient and precise.
This is exactly the kind of creative problem-solving we love to see. I will start using iris hooks this way and after you learn from the video, I am confident that you will do the same!
It is a great technique to avoid multiple paracentesis. Eager to know how easy to remove the hooks at the end through the needle track ? Thank you
just pull it out! so simple
I am sorry but this is not what I am watching. I am watching a sharp needle in a small anterior chamber with a high risk of puncturing the anterior capsule, a dreaded complication in this cases. I congratulate the surgeon for the maneuver but this should not mask the high risk complication rate of this technique in my point of view. I would like to know the technique used to avoid this complication