Iridectomy#Types
{{Short description|Surgical removal of part of the iris}}
{{Infobox interventions
| Name = Iridectomy |
Image = Large iridectomy deforms pupil.jpg|
Caption = Large peripheral iridectomy deforms pupil|
ICD10 = |
ICD9 = {{ICD9proc|12.1}} |
MeshID = D032801 |
synonyms = Surgical iridectomy|
}}
An iridectomy, also known as a surgical iridectomy or corectomy, is the surgical removal of part of the iris.Cline D; Hofstetter HW; Griffin JR. Dictionary of Visual Science. 4th ed. Butterworth-Heinemann, Boston 1997. {{ISBN|0-7506-9895-0}}[http://www.surgeryencyclopedia.com/Fi-La/Iridectomy.html Surgery Encyclopedia - "Iridectomy."] Encyclopedia of Surgery: A Guide for Patients and Caregivers. Retrieved May 20, 2006. These procedures are most frequently performed in the treatment of closed-angle glaucoma and iris melanoma.
Comparison with Nd:YAG laser iridotomy
File:Ancient Hindu iridectomy knives, one used by modern surgeons Wellcome M0003927.jpg
In acute angle-closure glaucoma cases, surgical iridectomy has been superseded by Nd:YAG laser iridotomy, because the laser procedure is much safer. Opening the globe for a surgical iridectomy in a patient with high intraocular pressure greatly increases the risk of suprachoroidal hemorrhage, with potential for associated expulsive hemorrhage. Nd:YAG laser iridotomy avoids such a catastrophe by using a laser to create a hole in the iris, which facilitates flow of aqueous humor from the posterior to the anterior chamber of the eye.{{cite web |url=https://www.brightfocus.org/glaucoma/article/side-effects-laser-iridotomy |title=Side Effects of Laser Iridotomy |first=Yvonne |last=Ou |publisher=University of California, San Francisco |date=5 July 2021 |access-date=23 February 2023 |website=www.brightfocus.org |archive-date=23 February 2023 |archive-url=https://web.archive.org/web/20230223201055/https://www.brightfocus.org/glaucoma/article/side-effects-laser-iridotomy |url-status=live }}
Current indications
Surgical iridectomy is commonly indicated and performed in the following cases:{{cn|date=January 2022}}
- Cataract surgery in a glaucoma patient
- Combined procedure for cataract and glaucoma
- Acute closed-angle glaucoma
- Posterior capsular tears with vitreous loss
- Implantation of anterior chamber IOL.
- Vitreoretinal procedure involving injection of silicone oil. The location of the iridectomy in such cases is at 6 o'clock, as opposed to routine iridectomy done at 11 to 1 o'clock. This is because silicone oil is less dense than water.
- Iris trauma
Types
- An antiphogistic iridectomy is the surgical removal of part of the iris to reduce intraocular pressure in inflammatory conditions of the eye.
- A basal iridectomy is an iridectomy which includes the root of the iris.
- An optical iridectomy is the surgical removal of part of the iris to enlarge the existing pupil, or to form an artificial pupil, when the natural pupil is ineffectual.
- A peripheral iridectomy is the surgical removal of a portion of the iris in the region of its root, leaving the pupillary margin and sphincter pupillae muscle intact. It is used in the treatment of glaucoma.
- A preliminary iridectomy, or preparatory iridectomy, is the surgical removal of part of the iris preceding cataract extraction. It facilitates the removal of the cataractous lens.
- A sector iridectomy, also known as a complete iridectomy or total iridectomy, is the surgical removal of a complete radial section of the iris extending from the pupillary margin to the root of the iris. A key-hole pupil is left by the removal of a wedge-shaped section of iris.Cassin, B. and Solomon, S. Dictionary of Eye Terminology. Gainesville, Florida: Triad Publishing Company, 1990.
- A stenopeic iridectomy is the surgical removal of a narrow slit or a minute portion of the iris, leaving the sphincter pupillae muscle intact.
- A therapeutic iridectomy is the surgical removal of a portion of the iris for the cure or prevention of an ocular disease.