“To Fulfill two needs with one deed”: Iris fixation of intraocular lens using four-throw pupilloplasty

BACKGROUND: Pupil distortion and aphakia are common complications that follow blunt injury of the eye globe, surgical complications, and iris coloboma. Patients with these two complications complain of severe glare and photophobia even after successful intraocular lens (IOL) implantation like scleral fixation of intraocular lens (SFIOL) due to irregular pupil. To overcome this, we prefer to do pupilloplasty along with IOL implantation. PURPOSE: In this video, we demonstrate iris fixation of IOL using four-throw pupilloplasty; thus with one surgical technique, both pupilloplasty and iris fixation are done. SYNOPSIS: The technique of an IOL implantation without capsular support can be challenging. There are different techniques, such as iris claw, iris fixation, and scleral fixation. Permanent mydriasis or distorted pupil can be a disabling condition, even after successful vision gain, due to photophobia. So pupilloplasty is nowadays preferred along with IOL implantation. Usually after IOL implantation, iris cerclage or pupilloplasty is done. We combined both steps with one technique: iris fixation with four-throw pupilloplasty. This technique can be used for iris coloboma with weak zonules and surgical iridectomy with aphakia cases where the pupil is irregular. HIGHLIGHTS: The video highlights the steps of four-throw pupilloplasty technique which is also used for fixating the IOL to the iris (iris fixation). This can give an excellent outcome in aphakia with distorted pupil using a single technique approach. VIDEO LINK: https://youtu.be/TEa54A5kg2I