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Chapter-12 Single-Pass Four-Throw Technique for Pupilloplasty

BOOK TITLE: Pre-Descemet’s Endothelial Keratoplasty (PDEK)

Author
1. Agarwal Amar
2. Narang Priya
ISBN
9789352703036
DOI
10.5005/jp/books/14154_13
Edition
1/e
Publishing Year
2018
Pages
8
Author Affiliations
1. Eye Research Centre and Dr. Agarwal’s Group of Eye Hospitals, Chennai, Bangalore, Trichy, Jaipur, Salem, Kerala, India, Dr Agarwal’s Group of Eye Hospitals and Eye Research Centre, 19 Cathedral Road Chennai, Tamil Nadu, India, Dr Agarwal’s Eye Hospital, 9, Cathedral Road, C,hennai, India, Dr Agarwal’s Eye Institute, 13 Cathedral Road, Chennai, India, Dr. Agarwal’s Eye Hospital, 19 Cathedral Road, Chennai, India, 15 Eagle Street, Langford Town Bangalore, India, Villa No. 2, Roundhouse 3, Al Wasl Road, Dubai PB 9168, Dubai, Dr. Agarwal’s Eye Hospital, 19 Cathedral Road, Chennai, India, 15 Eagle Street, Langford Town Bangalore, India, Villa No. 2, Roundhouse 3, Al Wasl Road, Dubai PB, Dubai, Dr Agarwal’s Group of Eye Hospitals, and Eye Research Centre, Chennai, India., Dr. Agarwal’s group of eye hospitals at Chennai, Bangalore, Jaipur, Salem and Trichy, India, Dr. Agarwal’s Eye Hospital, 19, Cathedral Road, Chennai-600086, India, Dr Agarwal’s Group of Eye Hospitals and Eye Research Centre 19,
2. Narang Eye Clinic, Ahmedabad (India), Narang Eye Clinic, Ahmedabad, India, M and I Institute of Ophthalmology, Ahmedabad, Narang Eye Hospital, Ahmedabad, Gujarat, India, Narang Eye Hospital Ahmedabad, Gujarat, India, Narang Eye Care and Laser Center, Ahmedabad, Gujarat, India
Chapter keywords
Single-pass four-throw, SFT pupilloplasty, anterior chamber, pre-Descemet’s endothelial keratoplasty, endoilluminator, trocar anterior chamber maintainer

Abstract

This chapter presents a brief discussion on single-pass four-throw (SFT) technique for pupilloplasty. The SFT pupilloplasty is a simple technique of repositioning the iris structure and pupil reconstruction with a single-pass four-throw technique, which entails intertwining of thread around itself that acts as a lock mechanism and ensures nonloosening of the loop. As the name suggests, a single pass of the 10-0 prolene suture on a long-arm needle is passed through the iris tissue followed by creation of a loop with four throws around it that slide inside the eye. This creates a helical configuration that prevents the suture from opening up. This is a modification of the Siepser sliding knot technique. The reason why pupilloplasty is connected to pre-Descemet’s endothelial keratoplasty (PDEK) or for that matter any endothelial keratoplasty (EK) technique is that in eyes without a capsule and endothelial damage, one performs a glued intraocular lens (IOL) procedure. The endoilluminator is used in most cases especially if the cornea is hazy when performing SFT. The advantage of SFT is that one just does one pass. The main issue in pupilloplasty is the pass. Every time a pass is made one has to enter the eye and there are chances of endothelium damage or iris damage or tapping the IOL producing a tilt or dislocation.

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