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a surgical procedure that makes an incision in the iris of the eye in order to enlarge the pupil or to treat closed-angle glaucoma

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出典(authority):フリー百科事典『ウィキペディア（Wikipedia）』「2013/10/07 20:24:28」(JST)

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An iridectomy, also known as a surgical iridectomy or corectomy, is the surgical removal of part of the iris.^[1]^[2] These procedures are most frequently performed in the treatment of closed-angle glaucoma and iris melanoma.^[2]

Comparison with Nd:YAG laser iridotomy[edit]

In acute angle-closure glaucoma cases, surgical iridectomy has been superseded by Nd:YAG laser iridotomy, because the laser procedure is much safer.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[edit]

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 IOL.
Vitreoretinal procedure involving injection of silicone 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 silicone oil is less dense than water.
Iris trauma

Types[edit]

An antiphogistic iridectomy is the surgical removal of part of the iris to reduce intraocular pressure in inflammatory conditions of the eye.^[1]
A basal iridectomy is an iridectomy which includes the root of the iris.^[1]
An optical iridectomy is the surgical removal of part of the iris to enlarge the existing pupil, or to form an artificial pupil, when the natural pupil is ineffectual.^[1]
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.^[1] It is used in the treatment of glaucoma.^[2]
A preliminary iridectomy, or preparatory iridectomy, is the surgical removal of part of the iris preceding cataract extraction.^[1] It facilitates the removal of the cataractous lens.^[2]
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.^[1] A key-hole pupil is left by the removal of a wedge-shaped section of iris.^[3]
A stenopeic iridectomy is the surgical removal of a narrow slit or a minute portion of the iris, leaving the sphincter pupillae muscle intact.^[1]
A therapeutic iridectomy is the surgical removal of a portion of the iris for the cure or prevention of an ocular disease.^[1]

References[edit]

^ ^a ^b ^c ^d ^e ^f ^g ^h ⁱ Cline D; Hofstetter HW; Griffin JR. Dictionary of Visual Science. 4th ed. Butterworth-Heinemann, Boston 1997. ISBN 0-7506-9895-0
^ ^a ^b ^c ^d Surgery Encyclopedia - "Iridectomy." Encyclopedia of Surgery: A Guide for Patients and Caregivers. Retrieved May 20, 2006.
^ Cassin, B. and Solomon, S. Dictionary of Eye Terminology. Gainsville, Florida: Triad Publishing Company, 1990.

UpToDate Contents

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1. 閉塞隅角緑内障 angle closure glaucoma
2. 眼の充血（red eye）の評価 evaluation of the red eye
3. 眼の待機手術に対する麻酔 anesthesia for elective eye surgery
4. 小児における水晶体偏位（水晶体脱臼） ectopia lentis dislocated lens in children
5. 急性持続性視力喪失が認められた成人に対するアプローチ approach to the adult with acute persistent visual loss

English Journal

Diurnal intraocular pressure changes in eyes affected with acute primary angle closure and fellow eyes after laser peripheral iridotomy.

Park HS1, Kim JM, Shim SH, Kim HT, Bae JH, Choi CY, Park KH.
Japanese journal of ophthalmology.Jpn J Ophthalmol.2015 Aug 4. [Epub ahead of print]
PURPOSE: To evaluate diurnal curves of intraocular pressure (IOP) in eyes affected with unilateral acute primary angle closure (APAC) after laser peripheral iridotomy (LPI), and fellow eyes.METHODS: The medical records of 22 female patients (44 eyes) with unilateral APAC and LPI performed OU were re
PMID 26239889

Subsequent Receipt of Interventions for Glaucoma Among a Nationwide Sample of Patients Who Underwent Laser Peripheral Iridotomy.

Bansal S1, Balakrishnan SA1, Blachley T1, Weizer JS1, Lee PP2, Stein JD3.
American journal of ophthalmology.Am J Ophthalmol.2015 Aug;160(2):275-282.e4. doi: 10.1016/j.ajo.2015.04.031. Epub 2015 Apr 30.
PURPOSE: To evaluate use of medical, laser, or incisional surgical interventions for glaucoma after laser peripheral iridotomy (LPI).DESIGN: Retrospective longitudinal cohort study.METHODS: All enrollees aged ≥21 years in a US managed-care network who underwent bilateral LPIs in 2001-2011 were ide
PMID 25935096

Changes of anterior chamber architecture induced by laser peripheral iridotomy in acute angle closure crisis.

Unterlauft JD1, Yafai Y, Wiedemann P.
International ophthalmology.Int Ophthalmol.2015 Aug;35(4):549-56. doi: 10.1007/s10792-014-9982-0. Epub 2014 Aug 2.
In acute angle closure crisis (AAC), a laser peripheral iridotomy (LPI) is performed to balance the pressure gradient between anterior and posterior chamber. The hereby induced changes in anterior chamber architecture were analyzed using Scheimpflug photography (SP). SP was performed in eyes with AA
PMID 25084747

Japanese Journal

うつむき位超音波生体顕微鏡検査を施行したレーザー虹彩切開術後に角膜内皮細胞が減少しているプラトー虹彩の2症例

今井和行,澤田英子,福地健郎
日本眼科学会雑誌 119(2), 68-76, 2015-02
NAID 40020356107

臨床報告レーザー虹彩切開術の長期経過後に角膜内皮細胞減少を生じた5症例7眼の白内障術後経過

具志堅直樹,大城さとみ,名幸宣子 [他]
臨床眼科 68(12), 1621-1629, 2014-11
NAID 40020243513

CLINICAL INVESTIGATION : Comparison of 2007–2012 Korean trends in laser peripheral iridotomy and cataract surgery rates

Kim Young Kook,Park Ki Ho
Japanese journal of ophthalmology : the official international journal of the Japanese Ophthalmological Society 58(1), 40-46, 2014-01
NAID 40019946896

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