3011: An unusual case of iridoschisis
Iridoschisis is a rare anterior segment pathology characterized by the separation of the anterior iris stroma from the underlying posterior stroma and dilator muscle. This unusual condition results in extremely fragile, frayed, and loose iris fibers that float freely in the anterior chamber, posing a high risk of iris prolapse, occlusion of the phaco tip, or progressive iris damage during intraocular surgery. Operating on these eyes requires exceptional fluidic management, heavy reliance on cohesive ophthalmic viscosurgical devices (OVDs) to tame the wispy iris tissue, and meticulous wound construction to prevent fluid egress from drawing the tissue into incisions. Watch the video to study the specialized techniques used to stabilize the anterior chamber and navigate around these compromised iris structures safely. Have you encountered iridoschisis in your practice, and what strategies do you use to keep the friable iris tissue away from the phaco tip? Please comment your experience and surgical pearls below.
