Where In God’s Name Should We Perform the Iridectomy?!

August 9, 2012

I was taught to put the iridectomy superiorly where it’s covered by the lid and therefore unlikely to cause symptoms from stray light. Then years later, I became aware of problems precisely at this location, especially when only partially covered by the lid, due to the prismatic effect of the tear meniscus, and so I started doing them temporally. I was also told a too-small iridectomy may diffract light and make symptoms worse. Now, an article in Ophthalmology shows that it makes no darn difference where it is or how small. I give up. Just put it anywhere you please.

 

 

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4 Responses to “Where In God’s Name Should We Perform the Iridectomy?!”

  1. David Richardson, MD on August 11th, 2012 9:54 pm

    I was taught the same but switched to nasal/termporal PIs after a number of patients with superior PIs complained bitterly about ghosting despite the PI entirely covered by the lid. Since moving to the nasal or temporal area I’ve not had a single complaint about ghosting (unintuitive as that may appear). The article may suggest that placement does not matter, but you’d have a hard time convincing me to go back to superior PIs.

  2. ari on August 12th, 2012 10:33 am

    im with you, sir, counter-intuitive as it seems.

  3. Nick on September 4th, 2012 1:13 pm

    Which article was this? Do you have the link?

  4. ari on September 10th, 2012 3:52 pm

    i apologize but cant recall exactly where the article is. likely july or august Ophthalmology journal

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