nebraska academy of eye physicians & surgeons · nebraska academy of eye physicians &...

Nebraska Academy of Eye Physicians & SurgeonsSeptember 21, 2019

Gregory S. H. Ogawa, MD

Eye Associates of New MexicoUniversity of New Mexico – Assistant Clinical Professor

Iris repair not needed until time of cataract surgerySphincter muscle runs in edge of coloboma pulling thepupil inferiorlyWhen widely dilated the coloboma may not look significantIf no coloboma repair w/ cat surg, then IOL edge inpupillary space with glare and poor visionSimple interrupted makes pupil very small, but stilldecentered

Cataract surgeryIf present, remove prolapsed vitreous firstWide tip capsule support hook, if need bag support at coloboma siteCTR or Sutured CTR, if significant zonular absence

Iris repairUse vitrector to remove sphincter muscle from sides of coloboma

Slowly and cautiously – watch for tension releaseMachine settings: slow cut rate, (60 cpm), low flow and vacuum

Approximate the appropriate pupil sphincter edges with an irissuturing techniqueClose the remaining radial iris defect with additional iris sutures