Iridectomy
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194363412
2008-02-27T06:23:35Z
Trutwister
6541969
added cpt code
{{Interventions infobox |
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ICD9 = 12.1 |
CPT = 66761
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An '''iridectomy''', also known as a '''surgical iridectomy''' or '''corectomy''', is the [[surgery|surgical]] removal of part of the [[Iris (anatomy)|iris]]<ref name="Cline">Cline D; Hofstetter HW; Griffin JR. ''Dictionary of Visual Science''. 4th ed. Butterworth-Heinemann, Boston 1997. ISBN 0-7506-9895-0</ref><ref name="Iridectomy">[http://www.surgeryencyclopedia.com/Fi-La/Iridectomy.html Surgery Encyclopedia - "Iridectomy."] Encyclopedia of Surgery: A Guide for Patients and Caregivers. Retrieved May 20, 2006.</ref>. These procedures are most frequently performed in the treatment of [[closed-angle glaucoma]] and iris [[melanoma]]<ref name="Iridectomy"/>.
==Comparison with Nd:YAG laser iridotomy==
In acute angle closure glauocma cases, surgical iridectomy has been superseded by [[Nd:YAG laser]] [[iridotomy]], because the laser procedure is much safer. Opening the globe for a surgical iridectomy in a patient with high [[intraocular pressure]] greatly increases the risk of [[suprachoroidal hemorrhage]], with potential for associated [[expulsive hemorrhage]]. Nd:YAG laser iridotomy avoids such a catastrophe by laser created hole in the iris, which facilitates flow of [[aqueous humor]] from the posterior to the [[anterior chamber]] of the eye.
==Current indications==
Surgical iridectomy is commonly indicated and performed in the following cases:
* Cataract surgery in a glaucoma patient
* Combined procedure for cataract and glaucoma
* Acute closed-angle glaucoma
* Posterior capsular tears with vitreous loss
* Implantation of anterior chamber [[intraocular lens|IOL]].
* Vitreoretinal procedure involving injection of [[silicon oil]]. The location of the iridectomy in such cases is at 6'O Clock, as opposed to routine iridectomy done at 11 to 1'O Clock. This is because [[silicon oil]] is lighter than water.
==Types==
*An '''antiphogistic iridectomy''' is the surgical removal of part of the iris to reduce intraocular pressure in inflammatory conditions of the eye<ref name="Cline"/>.
*A '''basal iridectomy''' is an iridectomy which includes the root of the iris<ref name="Cline"/>.
*An '''optical iridectomy''' is the surgical removal of part of the iris to enlarge the existing pupil, or to form an artificial pupil, whtn the natural pupil is ineffectual<ref name="Cline"/>.
*A '''peripheral iridectomy''' is the surgical removal of a portion of the iris in the region of its root, leaving the pupillary margin and sphincter pupillae muscle intact<ref name="Cline"/>. It is used in the treatment of glaucoma<ref name="Iridectomy"/>.
*A '''preliminary iridectomy''', or '''preparatory iridectomy''', is the surgical removal of part of the iris preceding [[cataract extraction]]<ref name="Cline"/>. It facilitates the removal of the [[cataract|cataractous]] [[lens (anatomy)|lens]]<ref name="Iridectomy"/>.
*A '''sector iridectomy''', also known as a '''complete iridectomy''' or '''total iridectomy''', is the surgical removal of a complete radial section of the iris extending from the pupillary margin to the root of the iris<ref name="Cline"/>. A ''key-hole pupil'' is left by the removal of a wedge-shaped section of iris<ref name="Cassin">Cassin, B. and Solomon, S. ''Dictionary of Eye Terminology''. Gainsville, Florida: Triad Publishing Company, 1990.</ref>.
*A '''stenopeic iridectomy''' is the surgical removal of a narrow slit or a minute portion of the iris, leaving the sphincter pupillae muscle intact<ref name="Cline"/>.
*A '''therapeutic iridectomy''' is the surgical removal of a portion of the iris for the cure or prevention of an ocular disease<ref name="Cline"/>.
==References==
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==See also==
*[[Eye surgery]]
*[[Glaucoma surgery]]
{{Eye surgery}}
[[Category:Surgery]]
[[Category:Ophthalmology]]
[[fr:Iridectomie]]
[[sv:Iridektomi]]