In this surgical case, Dr Amar Agarwal shares his brilliant, off-center, offset pinhole pupilloplasty technique for managing eyes with complex corneal pathology. While standard pupilloplasty often targets the anatomical center, this specific approach is dictated by a dense central corneal scar. Because the central cornea is opaque or highly irregular, a standard centered pupil would result in poor visual quality and light scattering. The key pearl is to strategically offset the 1.5 mm to stenopeic opening to a clearer portion of the mid-peripheral cornea. By utilizing the single-pass four-throw (SFT) pupilloplasty, we can precisely shift the aperture to align with a more transparent visual window. This maneuver effectively bypasses the central scar, utilizing the pinhole effect to provide the patient with a sharper, more functional image. Dr Agarwal demonstrates the intraocular suture maneuvers and the critical decision-making process required to determine the optimal location for the offset pupil to maximize the postoperative refractive outcome. And he narrates the video himself.
In search of top surgeon to repair my pupil which was damaged during a cataract surgery on my left eye in late 2024. . My vision is now blurry and sensitive to light. Im 71 yr old female which would like to regain my vision.