Pinhole Pupilloplasty for Managing High Astigmatism

In this interview from AAO 2018, Dr. Amar Agarwal discusses pinhole pupilloplasty, his new technique for managing patients with high astigmatism. This technique extends a patient’s depth of focus, helping improve near and far sight. Unlike other methods such as DALK, corneal surgery and pinhole IOLs, this method works at the pupil level. The key is a 1.5-mm sized pupil, created via either single-pass 4-throw pupilloplasty or other pupilloplasty methods. Pinhole pupilloplasty can be undone in the presence of retinal pathology using a YAG laser. A pinhole marker or microscope can help ensure the correct pinhole size.

Dr. Agarwal's pinhole pupilloplasty technique has been accepted for publication and is available online in the Journal of Cataract & Refractive Surgery. 

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