3053: traumatic cataract with iridodialysis
Managing a traumatic cataract with fibrotic capsule changes, zonular loss, and an iridodialysis presents a formidable challenge, and this surgeon does a great job with this tough case. To address the traumatic iridodialysis, the goal is to use suture to re-anchor the peripheral iris root back to the scleral spur. Reattaching the dialysis helps close the peripheral pseudophakic gap and reduces the risk of post-operative glare and monocular diplopia. However, pairing the peripheral repair with a formal pupilloplasty, such as a 4-throw knot or a cerclage suture, at the conclusion of the case would have further restored the central aperture. Tightening the stretched, irregular sphincter margin improves depth of field, enhances cosmesis, and mitigates photopic dysphotopsias for a truly comprehensive anterior segment reconstruction. Watch the video to see the step-by-step iridodialysis repair and analyze the surgical steps involved in managing severe post-traumatic pathology. What are your preferred suturing techniques for combining iridodialysis repair with central pupilloplasty in heavy trauma cases? Please comment your thoughts below.
