Modified Intrascleral Suture Technique for Repairing Iridodialysis Combined with Phacoemulsification Cataract Surgery

To introduce a modified intrascleral suture technique (MIST) for repairing iridodialysis combined with phacoemulsification cataract surgery and evaluate its efficacy. We retrospectively analyzed the clinical characteristics and surgical outcomes of patients undergoing iridodialysis repair and cataract surgery (2018–2023). Twelve eyes received MIST, and eleven received the modified sewing-machine technique (MSMT). Both techniques utilized the closed-chamber sewing-machine principle of suture loop formation. MIST utilized a 10-0 polypropylene suture with long straight and short curved needles, guided by a 26-gauge syringe tip for intrascleral suturing. MSMT involved creating a partial-thickness scleral tunnel, through which a prethreaded needle with 10-0 polypropylene suture was passed for fixation. Iridodialysis was successfully repaired in all patients. The median procedure time was significantly shorter in the MIST group (25 min, IQR: 24.0–27.5) than in the MSMT group (34 min, IQR: 29.0–35.0; p p = 0.08), the median BCVA was better in the MIST group (0.1 logMAR, IQR: 0.0–0.4) than the MSMT group (0.4 logMAR, IQR: 0.1–0.6). Complication rates were comparable between groups. The MIST technique provides a minimally invasive alternative for iridodialysis repair by eliminating the need for conjunctival or scleral dissection. This approach significantly reduces operative time while maintaining surgical efficacy and safety, making it a valuable option for combined iridodialysis and cataract surgery.

本研究旨在介绍一种用于联合超声乳化白内障手术（phacoemulsification cataract surgery）治疗虹膜根部离断（iridodialysis）的改良巩膜内缝合技术（MIST），并评估其临床疗效。本研究回顾性分析了2018年至2023年间接受虹膜根部离断修复联合白内障手术的患者的临床特征与手术结局。其中12只患眼采用MIST治疗，11只患眼采用改良缝纫机技术（MSMT）治疗。两种技术均采用闭合腔室缝纫机原理完成缝合环的构建。MIST采用带长直针与短弯针的10-0聚丙烯缝线，以26G注射器针头作为引导完成巩膜内缝合。MSMT则需制作部分厚度巩膜隧道，将穿有10-0聚丙烯缝线的预穿针经此隧道穿过以完成固定。所有患者的虹膜根部离断均成功修复。MIST组的手术中位时长（25分钟，四分位间距：24.0~27.5）显著短于MSMT组（34分钟，四分位间距：29.0~35.0；p=0.08）。MIST组的中位最佳矫正视力（BCVA, Best Corrected Visual Acuity）为0.1 logMAR，四分位间距0.0~0.4，优于MSMT组的0.4 logMAR（四分位间距0.1~0.6）。两组的并发症发生率无显著差异。MIST技术无需进行结膜或巩膜剥离，为虹膜根部离断修复提供了一种微创选择。该术式可在维持手术疗效与安全性的同时显著缩短手术时长，为虹膜根部离断联合白内障手术提供了极具价值的治疗选择。