A 1-mm paracentesis is created as described previously. After the installation of a miotic agent followed by a cohesive viscoelastic through the paracentesis, the long curved CIF-4 needle on a 10-0 polypropylene suture can be gently introduced via the paracentesis. The needle can be passed through the proximal iris leaflet, across the defect, and then through the distal iris leaflet. The needle can then be passed through the peripheral cornea at a point in a straight line from the paracentesis incision. Adequate suture should be pulled through the anterior chamber to allow the suture to double- back across the anterior chamber. At least 4cm of suture tail should be allowed to remain outside of the paracentesis incision. At this point, the suture will be crossing the anterior chamber, entering through the 7 o’clock paracentesis incision, through the anterior surface of the proximal iris leaflet, across the iris defect, through the posterior surface of the distal iris leaflet, and then out through the peripheral cornea, all in a straight line across the bottom third of the anterior segment. During the needle passes through the iris leaflet, counter- traction on the iris with an intraocular forceps may be desirable to prevent stretching, tearing, or distortion of the iris. In this case, an inferior paracentesis should be, created and the intraocular microforceps can be used to hold the iris leaflet secure as the needle pass is made. Once both of the iris leaflets are engaged by the suture and the needle has exited out of the distal limbus, then a small instru­ment, such as a Kuglen hook, is now passed through the paracentesis and engaged with the suture filament beyond the distal iris leaflet. Pulling slowly and smoothly, this loop of suture is then externalized via the paracentesis. At this moment, the surgeon should carefully ensure that the loop of suture and the proximal strand of suture are not entangled within the eye or in the corneal wound. The proximal suture strand and the 2 strands of the suture loop will all pass through the paracentesis and should be properly aligned in a parallel fashion. The proximal suture tail is then passed into the suture loop from above and wrapped twice around the middle strand of the suture loop, with the suture passes advancing toward the paracentesis. The outside strand of the loop should pass through the paracentesis, across the anterior chamber, and exit directly through the edge of the cornea. Now the 2 suture tails can be gently pulled away from each other causing the initial 2- throw knot to gently slip into the eye and cinch together the 2 iris leaflets. Great care should be taken to ensure even tension on each suture tail to make sure that no undue traction is placed across the iris. Failure to exercise caution with equal tension may lead to tearing of the iris tissue or disinsertion of the iris root. Either injury can lead to excessive bleeding that may quickly degrade the surgeon’s view and prevent continued repair of the iris defect. Once the initial 2- throw loop has been cinched gently yet securely to close the iris defect, then the sequence of retrieving a loop of the distal suture and ensuring the loop exits the paracentesis without tangling is repeated. At this time, a single throw of the free suture tail is done through the loop from the bottom of the loop. Once again gentle, even traction is placed across both suture tails, and the loop with the sec­ond suture throw is pulled into the eye, locking the knot upon gentle tightening. A second single­throw pass is accomplished in exactly the same manner to fi nally secure the knot within the eye. The intraocular scissors are now introduced through the paracentesis, and the suture tails are cut close to the knot. The cut tails are removed from the eye. In many cases, 2 or 3 interrupted sutures may be required to close a linear iris defect. Each suture is passed and tied in the same manner.