3025: traumatic iridodialysis – fix the cataract and the iris
Addressing a significant peripheral iridodialysis at the time of cataract surgery requires a coordinated, step-by-step strategy to restore both optical clarity and anterior segment architecture. In this trauma reconstruction, the surgeon carefully maneuvers to reattach the disinserted iris root back to its anatomical position at the scleral spur using trans-scleral mattress suturing, successfully eliminating the peripheral defect and restoring a round pupil to prevent post-operative glare and monocular diplopia. Prior to the iris stabilized and the anterior chamber anatomical relationship re-established, the cataract extraction and IOL implantation proceeds safely under viscoelastic support. Watch the video to analyze the suture pass techniques and fluidic control required for combined iris-fixation and phacoemulsification. If you are trying this for the first time, I suggest using an iris hook or two to keep the dis-inserted iris away from the phaco probe during cataract surgery. What is your go-to technique for repairing a large traumatic iridodialysis during cataract surgery? Please comment your pearls below.
