Single-Pass 4-Throw Technique for Pupil Reconstruction

In this interview from AAO 2017, Dr. Amar Agarwal discusses a new option for pupilloplasty: the single-pass 4-throw technique. The method, which is demonstrated in this clinical video, employs an initial approximating loop followed by 4 throws. This creates a modified Siepser slipknot that is self-retaining and self-locking. Dr. Agarwal finds that the method is particularly useful in patients who have previously undergone endothelial keratoplasty, because the single pass minimizes graft detachment risk. Additionally, he suggests that the technique can be used in place of a trabeculectomy or drainage device in patients with closed-angle glaucoma where the iris is stuck to the endothelium.