1. Surgical Peripheral Iridectomy In Implantable Collamer Lens Procedure
in Brown Irides
Dr. Prasad Kasu Reddy
Maxivision Eye Clinic
Hyderabad, India

2. STUDY PURPOSE STAAR Surgicals recommended 2 Yag Laser
Peripheral Iridectomies pre-operatively and portal incisions in ICL procedure
AIM
To use one portal incision at 12 ‘O’ clock for manipulating the ICL and same portal incision for surgical PI
To analyze surgical iridectomies in ICL procedure
in patients with brown iridies
To discuss the method of Surgical PI

3. STUDY DESIGN Source : Maxivision Eye Clinic, Hyderabad, India
No. of Cases Studied : eyes from 60 patients
Study Period : July 2005 to September 2007
Clinical History : High Myopes with low pachymetry with mean Anterior chamber Depth of 2.8mm

4. METHODOLOGY One Portal Incision (12 o’ clock) ICL Manipulation
Surgical PI
( after constricting the pupil with pilocar)
Gently pulling the iris through the same port
( using Hoskins forceps)
Iridectomy
( using Vannus scissors)
(An age old technique)
Incomplete PI Completed PI
(Left with a posterior (piece-meal removal of smooth pigmented layer) pigmented layer)
Irrigation Aspiration

5. POST SURGICAL OBSERVATIONS
Clinical examination of all the patients was done on :
- 1st post op day months post op
- 1st week post op - yearly examination
- 4 week post op
- 3 months post op
All PI’s were patent
Intra Ocular Pressures ranged from 16-26mm of Hg
10 eyes showed elevation of Intra Ocular Pressure

6. RESULTS The increase in Intra Ocular Pressure was transient,
as these patients were found to be steroid responders
These patients were treated with anti-glaucoma
medication and switched over to voveron optha that
controlled the IOP

7. In Brown Iridies Surgical PI Thorough I & A 2 Yag Laser PI’s
Can Disperse
pigment
No Pigment
Dispersion
No block,
Trabecular meshwork
Block
trabecular
meshwork
Chronic Rise in IOP
No rise in IOP

8. CONCLUSION One portal manipulation of ICL and surgical
peripheral iridotomy
is advantageous and effective.

9. H:\Dr Sanders\My Documents\Orbtek_9-21\ PosteriorKeraRevShort
H:\Dr Sanders\My Documents\Orbtek_9-21\ PosteriorKeraRevShort.ppt (10-98)
9/25/2019
Thank you