Small incision surgical iridotomy and iridectomy

Purpose To describe a minimally invasive method to create a full-thickness surgical iridectomy. Design An interventional case series. Methods Surgical iridectomies were performed through a 1-mm clear corneal incision. The anterior chamber was prepared with acetylcholine chloride 10 mg/ml and sodium hyaluronate 1%. A 25-gauge aspiration-cutter “probe” was introduced through the corneal incision such that the aspiration portal was occluded by the iris stroma. Then aspiration (600 mm/Hg) cutting (300 cpm) was used to create a surgical iridotomy in 2 cases. Then the probe was removed. Results Full-thickness iridotomies were created. None of the patients were noted to have a secondary increase in intraocular pressure, hyphema, infection, cataract or vision loss. The clear-corneal wounds were self-sealing. Conclusions Small incision surgical iridectomy can be minimally invasive and effective. Use of a 25-gauge aspiration-cutting probe allowed for small incision surgery, rapid rehabilitation and no significant complications. Supported by The EyeCare Foundation, Research to Prevent Blindness, and The New York Eye and Ear Infirmary Research Fund, New York City, New York, USA