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Editors
Ashvin Agarwal, MBBS, MS
Chief of Clinical Ser vices
Director
Dr.Agarwal’s Group of Eye Hospitals and
Eye Research Centre
Chennai, India
Amar Agarwal, MS, FRCS, FRCOphth
Chairman and Managing Director
Dr.Agarwal’s Group of Eye Hospitals and
Eye Research Centre
Chennai, India
Associate Editor
Priya Narang, MS
Director
Narang Eye Care & Laser Centre
Ahmedabad, India

First published 2021 by SLACK Incorporated
Published 2024 by CRC Press
2385 NW Executive Center Drive, Suite 320, Boca Raton FL 33431
and by CRC Press
4 Park Square, Milton Park, Abingdon, Oxon, OX14 4RN
CRC Press is an imprint of Taylor & Francis Group, LLC
© 2021 Taylor & Francis Group, LLC
This book contains information obtained from authentic and highly regarded sources. While all reasonable efforts have
been made to publish reliable data and information, neither the author[s] nor the publisher can accept any legal
responsibility or liability for any errors or omissions that may be made. The publishers wish to make clear that any views
or opinions expressed in this book by individual editors, authors or contributors are personal to them and do not
necessarily reflect the views/opinions of the publishers. The information or guidance contained in this book is intended
for use by medical, scientific or health-care professionals and is provided strictly as a supplement to the medical or other
professional’s own judgement, their knowledge of the patient’s medical history, relevant manufacturer’s instructions and
the appropriate best practice guidelines. Because of the rapid advances in medical science, any information or advice on
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national drug formulary and the drug companies’ and device or material manufacturers’ printed instructions, and their
websites, before administering or utilizing any of the drugs, devices or materials mentioned in this book. This book does
not indicate whether a particular treatment is appropriate or suitable for a particular individual. Ultimately it is the sole
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Trademark notice: Product or corporate names may be trademarks or registered trademarks and are used only for
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Cover Artist: Katherine Christie
Library of Congress Cataloging-in-Publication Data
Names: Agarwal, Ashvin, editor. | Agarwal, Amar, editor. | Narang, Priya,
editor.
Title: Mastering iris repair : a video textbook of iris repair and
pupilloplasty techniques / editors, Ashvin Agarwal, Amar Agarwal ;
associate editor, Priya Narang.
Description: Thorofare, NJ : SLACK Incorporated, [2021] | Includes
bibliographical references and index.
Identifiers: LCCN 2020018755 (print) | ISBN
9781630917289
ISBN
Su bjects: MESH: Iris Diseases--surgery | Iris--surgery | Pupil
Disorders--surgery | Reconstructive Surgical Procedures--methods
Classification: LCC RE352 (print) | NLM WW 240 | DDC
617.7/2--dc23
LC record available at https://lccn.loc.gov/2020018755
ISBN: 9781630917265 (pbk)
ISBN: 9781003525028 (ebk)
DOI: 10.1201/9781003525028
9781630917265 (paperback) |
Additional resources can be found at
https://www.routledge.com/9781630917265

DEDICATION
This book is dedicated to GeorgeO. Waring IV, MD, FACS, a great human being and surgeon.


CONTENTS
Dedication . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . v
Website Contents . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .xi
Acknowl edgment . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .xv
About the Editors . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . xvii
Contributing Authors . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . xix
Preface . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . xxi
Foreword by WilliamB. Trattler, MD . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . xxiii
SectionI Iris Repair Techniques . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1
Chapter1 Introduction, Indications, and Salient Points of Iris Tissue and Repair . . . . . . . . . . 3
Dhivya Ashok Kumar, MD, FRCS, FICO, FAICO and
Amar Agarwal, MS, FRCS, FRCOphth
Case Pre sen ta tion. Cigarette Lighter Injury . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 11
Dhivya Ashok Kumar, MD, FRCS, FICO, FAICO and
Amar Agarwal, MS, FRCS, FRCOphth
Chapter2 Mastering the McCannel Suture and Modified McCannel Suture Techniques . . . 13
AlanS. Crandall, MD
Case Pre sen ta tion. Modified McAhmed Suture Technique . . . . . . . . . . . . . . . . . . 18
StevenG. Safran, MD
Chapter3 Mastering the Siepser Iris Suture Technique . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 21
Yuri McKee, MD and Ashvin Agarwal, MBBS, MS
Case Pre sen ta tion. Cionni Technique for Iris Coloboma Repair . . . . . . . . . . . . . . 25
RobertJ. Cionni, MD
Chapter4 The Iris Cerclage Suture . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 27
BrandonD. Ayres, MD
Case Pre sen ta tion. Subluxated Intraocular Lens in a Large Eye
With Iris Cerclage . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 33
Priya Narang, MS; Ashvin Agarwal, MBBS, MS; and
Amar Agarwal, MS, FRCS, FRCOphth
Chapter5 Mastering the Single- Pass Four- Throw Pupilloplasty . . . . . . . . . . . . . . . . . . . . . . . 35
Priya Narang, MS; Ashvin Agarwal, MBBS, MS; Ashar Agarwal, MS, FRCS; and
Amar Agarwal, MS, FRCS, FRCOphth
Case Pre sen ta tion 1. Single- Pass Four- Throw Pupilloplasty . . . . . . . . . . . . . . . . . . 44
Priya Narang, MS and Amar Agarwal, MS, FRCS, FRCOphth
Case Pres ent at ion 2. Yamane Technique With Single-P ass Four-Th row
Pupilloplasty . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 45
SadeerB. Hannush, MD

viii Contents
Chapter6 Iridodialysis Repair Management . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 47
RichardS. Hoffman, MD; Ashvin Agarwal, MBBS, MS; Priya Narang, MS; and
Amar Agarwal, MS, FRCS, FRCOphth
Case Pre sen ta tion 1. Sewing Machine Technique for Iridodialysis Repair . . . . . . . 56
Ashvin Agarwal, MBBS, MS
Case Pres ent at ion 2. Modified Sewing Machine Technique for Iridodialysis Repair,
Intraocular Lens Relocation, Iris Coloboma Repair, Cionni Ring Fixation, and
Scleral Fixated Intraocular Lens . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 57
Ravi Kumar K V, PGDO, FCO (LVPEI), FICO (SWISS)
SectionII Iris Repair and Pupilloplasty Special Topics . . . . . . . . . . . . . . . . . . . . . . . . . . . 59
Chapter7 Pupilloplasty in Special Indications:
Urrets- Zavalia Syndrome and Secondary Glaucoma . . . . . . . . . . . . . . . . . . . . . . . 61
Priya Narang, MS and Amar Agarwal, MS, FRCS, FRCOphth
Case Pres ent a tion 1. Urrets-Zavalia Syndrome Post Penetrating Keratoplasty . . . . 67
Priya Narang, MS and Amar Agarwal, MS, FRCS, FRCOphth
Case Pres ent a tion 2. Surgical Pupilloplasty in Angle-C losure Glaucoma . . . . . . . . 68
Amar Agarwal, MS, FRCS, FRCOphth
Chapter8 Pupilloplasty in Compartmentalizing the Eye: Endothelial Keratoplasty
Including Pre-D escemet’s Endothelial Keratoplasty With
Glued Intraocular Lens/Yamane Technique . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 71
Amar Agarwal, MS, FRCS, FRCOphthand Priya Narang, MS
Case Pres ent at ion 1. Triple Procedure of Pre- Descemet’s Endothelial Keratoplasty
With Glued Intraocular Lens and Single- Pass Four- Throw Pupilloplasty . . . . . . . 81
Amar Agarwal, MS, FRCS, FRCOphth and Priya Narang, MS
Case Pre sen ta tion 2. Yamane Technique. Flanged Intrascleral
Intraocular Lens Fixation With Double- Needle Technique . . . . . . . . . . . . . . . . . . 84
Shin Yamane, MD, PhD
Chapter9 Iris Prosthesis Devices . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 87
DavidT. Truong, MD and KevinM. Miller, MD
Case Pre sen ta tion 1. Aniridia Rings . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 93
Priya Narang, MS; Ashvin Agarwal, MBBS, MS; and
Amar Agarwal, MS, FRCS, FRCOphth
Case Pre sen ta tion 2. Sutured Artificial Iris . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 94
MichaelE. Snyder, MD
Case Pres ent at ion 3. Artificial Iris With Yamane Technique. Double-Needle
Scleral Intraocular Lens and Artificial Iris Fixation . . . . . . . . . . . . . . . . . . . . . . . . 95
Vladimir Pfeifer, MD, FEBOS-CR
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