VT296 : Pupil reconstruction in traumatic aniridia using purse string suture.

Dr.Ekta Rishi

This video describes a novel technique of pupil reconstruction in blunt trauma patients.A soldier with traumatic aniridia, aphakia and retinal reattachment surgery came for IOL fixation. A stump of retroflexed iris seen all around on scleral depression. It was managed by pupil reconstruction with purse string suture using 10-0 polypropylene suture with straight needle by puling the iris stump with engripping forcep. Corneal entries were used to externalise and change the direction of needle with the help of 30 G needle to cover 360 degrees of iris. A 3 piece acrylic IOL was glue fixated under the scleral flaps using handshake technique. Size of the pupil was adjusted by suture tightening and the knot was finalised and slipped over the iris. Patient maintained 6/12 vision with no glare or inflammation and a 4 mm pupil at 3 years. It is a safe technique for retroflexed iris in patients with blunt trauma and has no description in published literature.