Iridodialysis Repair after penetrant ocular trauma

This is a video shared by Dr. Micael Valtoni from Mossoró Brazil.

This is a case of a patient previously submitted to scleral sutures and anterior chamber washout after penetrating ocular trauma in his left eye 2 months ago. CT scans didn’t show the presence of an Intraocular foreign body, but because of persistent vitreous hemorrhage and traumatic cataract a second procedure was indicated.

After phacoemulsification and IOL implant, the anterior vitreous and capsular opacities were removed. It’s possible to see a residual vitreous hemorrhage inferiorly and a fibrotic epiretinal membrane nasally in the midperiphery.

After staining with both triamcinolone and trypan blue,the surgeon removed carefully the Posterior hyaloid and the epiretinal membrane. There weren’t retinal breaks in the periphery and the endolaser was made only in the area of the dense membrane removed.

In the end of the surgery, repair of iridodialysis was made.

First, a conjunctival dissection is made nasally followed by cauterization and a scleral sulcus. A 30-gauge needle is passed through the iris root, out of the angle. A double-armed, 10-0 polypropylene suture is passed through a contralateral paracentesis and it is grasped with the needle.

The same maneuver is made again to fix the iridodialysis area, and the knot is tied on the surface of the globe under the scleral sulcus.

Micael Valtoni MD

Filipe Lucatto MD
Juliana Prazeres MD