McCannel Suture Technique Resolves Persistent Dysphotopsia Following Laser Peripheral Iridotomy in Phakic Eyes. 2021

Matthew P Nicholas, and Tara Vaz, and Sana Idrees, and Shakeel Shareef
Cole Eye Institute, Cleveland Clinic Foundation.

A 57-year-old woman presented with photophobia and complaint of a persistent white light in the inferior field of her left eye for 18 months following laser peripheral iridotomy both eyes. In primary gaze, the upper lid margin was noted to bisect the iridotomy at 2 o'clock left eye (OS). She relates that the light moves with her eyelid OS only and resolves by lifting the lid. A 54-year-old male presented with complaint of seeing 2 horizontal lines in his field of vision immediately following laser iridotomy OS that have persisted for a duration of 7 years. He notes they are constant and resolve by lifting up the eyelid. In primary position, the left upper lid margin was noted to bisect the iridotomy at 12 o'clock OS. Given the presence of nonresolving symptomatic dysphotopsia, each patient underwent surgical repair of the iridotomy using a McCannel suture technique with complete resolution of their symptoms. Dysphotopsias are an uncommon complication that can occur following laser peripheral iridotomy. If they persist and conservative measures are ineffective, iris suture repair can provide a definitive intervention in resolving them. Laser iridotomies located in the far periphery pose a surgical challenge with respect to accessibility. A McCannel suture technique provides a feasible approach in suturing them with minimal iris manipulation. Furthermore, it is prudent to assess the upper lid position in primary gaze before creating an iridotomy in order to avoid interference with the lid margin tear film meniscus that can lead to the formation of symptomatic dysphotopsia.

UI MeSH Term Description Entries
D007429 Intraocular Pressure The pressure of the fluids in the eye. Ocular Tension,Intraocular Pressures,Ocular Tensions,Pressure, Intraocular,Pressures, Intraocular,Tension, Ocular,Tensions, Ocular
D007498 Iris The most anterior portion of the uveal layer, separating the anterior chamber from the posterior. It consists of two layers - the stroma and the pigmented epithelium. Color of the iris depends on the amount of melanin in the stroma on reflection from the pigmented epithelium.
D007834 Lasers An optical source that emits photons in a coherent beam. Light Amplification by Stimulated Emission of Radiation (LASER) is brought about using devices that transform light of varying frequencies into a single intense, nearly nondivergent beam of monochromatic radiation. Lasers operate in the infrared, visible, ultraviolet, or X-ray regions of the spectrum. Masers,Continuous Wave Lasers,Pulsed Lasers,Q-Switched Lasers,Continuous Wave Laser,Laser,Laser, Continuous Wave,Laser, Pulsed,Laser, Q-Switched,Lasers, Continuous Wave,Lasers, Pulsed,Lasers, Q-Switched,Maser,Pulsed Laser,Q Switched Lasers,Q-Switched Laser
D008297 Male Males
D008875 Middle Aged An adult aged 45 - 64 years. Middle Age
D005260 Female Females
D006801 Humans Members of the species Homo sapiens. Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D013536 Suture Techniques Techniques for securing together the edges of a wound, with loops of thread or similar materials (SUTURES). Suture Technics,Suture Technic,Suture Technique,Technic, Suture,Technics, Suture,Technique, Suture,Techniques, Suture
D015812 Glaucoma, Angle-Closure A form of glaucoma in which the intraocular pressure increases because the angle of the anterior chamber is blocked and the aqueous humor cannot drain from the anterior chamber. Glaucoma, Closed-Angle,Glaucoma, Angle Closure,Glaucoma, Narrow-Angle,Glaucoma, Uncompensated,Glaucoma, Uncompensative,Angle Closure Glaucoma,Angle Closure Glaucomas,Angle-Closure Glaucoma,Angle-Closure Glaucomas,Closed-Angle Glaucoma,Closed-Angle Glaucomas,Glaucoma, Closed Angle,Glaucoma, Narrow Angle,Glaucomas, Angle Closure,Glaucomas, Angle-Closure,Glaucomas, Closed-Angle,Glaucomas, Narrow-Angle,Glaucomas, Uncompensated,Glaucomas, Uncompensative,Narrow-Angle Glaucoma,Narrow-Angle Glaucomas,Uncompensated Glaucoma,Uncompensated Glaucomas,Uncompensative Glaucoma,Uncompensative Glaucomas
D053685 Laser Therapy The use of photothermal effects of LASERS to coagulate, incise, vaporize, resect, dissect, or resurface tissue. Laser Knife,Laser Scalpel,Surgery, Laser,Vaporization, Laser,Laser Ablation,Laser Knives,Laser Photoablation of Tissue,Laser Surgery,Laser Tissue Ablation,Nonablative Laser Treatment,Pulsed Laser Tissue Ablation,Ablation, Laser,Ablation, Laser Tissue,Knife, Laser,Knifes, Laser,Knive, Laser,Knives, Laser,Laser Knifes,Laser Knive,Laser Scalpels,Laser Surgeries,Laser Therapies,Laser Treatment, Nonablative,Laser Treatments, Nonablative,Laser Vaporization,Nonablative Laser Treatments,Scalpel, Laser,Scalpels, Laser,Surgeries, Laser,Therapies, Laser,Therapy, Laser,Tissue Ablation, Laser

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