An iridectomy is a surgical procedure involving the removal of a small piece of the iris, the colored part of the eye. This intervention is performed by an ophthalmologist to create a new channel for fluid to move within the eye. The primary purpose is to re-establish a healthy circulatory pattern for the aqueous humor, the clear fluid that fills the front of the eyeball. By creating this alternate route, the procedure helps to regulate the eye’s internal pressure.
Medical Conditions Treated by an Iridectomy
The most common reason for performing an iridectomy is to treat angle-closure glaucoma. This condition occurs when the drainage angle between the iris and the cornea becomes too narrow or completely blocked. Aqueous humor gets trapped, causing a rapid and painful increase in intraocular pressure (IOP).
This procedure is used in cases of acute angle-closure glaucoma, a medical emergency that can lead to severe eye pain, nausea, and permanent vision loss if not treated quickly. Before the surgery, an ophthalmologist will confirm the diagnosis using tests like tonometry, which measures IOP, and gonioscopy, which assesses the eye’s drainage angle.
Less frequently, an iridectomy is performed for other reasons. One such instance is the removal of an iris melanoma, a type of cancerous tumor. The procedure may also be used to correct complications from other eye surgeries or to improve vision by creating an artificial pupil when the natural one is obscured, a technique known as an optical iridectomy.
The Surgical Procedure
An incisional, or surgical, iridectomy is an outpatient procedure performed under local anesthesia. The process begins with the administration of anesthetic eye drops to numb the surface of the eye. In some instances, a mild sedative may be offered to help the patient relax during the operation.
The surgeon makes a tiny incision at the limbus, the border where the cornea meets the sclera (the white of the eye). Through this opening, a minute, triangle-shaped piece of the peripheral iris is carefully grasped and excised. Once the tissue is removed, the incision is closed, sometimes with a dissolvable suture, though often the wound is small enough to self-seal.
It is important to distinguish a surgical iridectomy from a laser iridotomy. While both procedures aim to create an opening in the iris, a laser iridotomy uses a focused laser to create a small hole without removing tissue. An incisional iridectomy is a more invasive approach that is reserved for situations where a laser procedure is not suitable or has failed. The surgical method allows for a larger opening and the physical removal of tissue.
Post-Operative Care and Healing
Immediately following the surgery, the patient’s vision will likely be blurry, and they may experience mild soreness or a gritty sensation in the eye. To protect the eye from accidental bumps and bright light, a protective shield or patch is often worn for a few days. The surgeon will check the intraocular pressure shortly after the procedure to confirm it has been successfully lowered.
The healing process unfolds over several weeks. Patients are prescribed a course of antibiotic and anti-inflammatory eye drops to prevent infection and reduce swelling. Following up with the ophthalmologist for scheduled appointments is necessary to monitor the healing process and ensure the eye’s pressure remains stable.
During the recovery period, certain activities must be avoided to prevent complications. Patients are advised to refrain from strenuous exercise, heavy lifting, swimming, and rubbing the eye for approximately three weeks. While complications are uncommon, any signs of increasing pain, significant vision loss, or persistent redness should be reported to the eye care professional immediately.