Purpose of review: When patients have large iris defects, they may experience debilitating glare, halos, and unfavorable cosmetic appearance. Surgical iris reconstruction can alleviate these symptoms. This article will review current suturing techniques for iris reconstruction, as well as the benefits and drawbacks to various suturing methods. Alternative reconstructive methods are also discussed.
Recent findings: One of the earliest iris suturing methods described was the McCannel technique. This technique allows direct suturing of the iris using three incisions. The Siepser slipknot is another method used in closed chamber iris suturing techniques. This knot, and its recent modifications, utilizes a sliding knot, which is created outside the eye and slid into place atop the iris defect. The cerclage iris suture, in which small bites are taken around the pupillary circumference, is especially useful when treating a mydriatic pupil. Recently, a number of surgeons have adapted these techniques and developed novel suturing strategies to address complex ocular conditions.
Summary: The various iris suturing methods, as well as alternative techniques including cautery, corneal tattooing, and iris prosthetics, each have unique benefits, providing surgeons with a wide array of tools for iris reconstruction.