Centration of an Inferior Iris Defect

In this video, Dr. Ike Ahmed repairs an iris defect in a patient with corectopia. For these procedures, Dr. Ahmed prefers a closed-system with micro-instrumentation and multiple paracenteses to allow for an ergonomic approach. To begin, a curved needle with 10-0 polypropylene is passed through the iris leaflets and emerges from the anterior chamber through the corneal incision. Dr. Ahmed uses 2 microtyers to pull the 2 iris leaflets together, locking with a reverse throw. It is important to keep 1 of the microtyers out of the eye to tighten the suture. Cautery is used to create a more circular and contoured iris-pupillary margin. The iris defect is finally closed completely with more suture bites placed approximately 0.5 to 1 mm from the pupil margin. The result is a centered pupil with an improved cosmetic appearance.