Small incision surgical iridotomy and iridectomy

Purpose: To describe a minimally invasive method to create a full-thickness surgical iridectomy. Design: An interventional case series. Methods: Surgical iridectomies were performed through a 1-mm clear corneal incision. The anterior chamber was prepared with acetylcholine chloride 10 mg/ml and sodium hyaluronate 1%. A 25-gauge aspiration-cutter "probe" was introduced through the corneal incision such that the aspiration portal was occluded by the iris stroma. Then aspiration (600 mm/Hg) cutting (300 cpm) was used to create a surgical iridotomy in 2 cases. Then the probe was removed. Results: Full-thickness iridotomies were created. None of the patients were noted to have a secondary increase in intraocular pressure, hyphema, infection, cataract or vision loss. The clear-corneal wounds were self-sealing. Conclusions: Small incision surgical iridectomy can be minimally invasive and effective. Use of a 25-gauge aspiration-cutting probe allowed for small incision surgery, rapid rehabilitation and no significant complications.