Iridectomy

Definition

Excision of a section of the iris.

Discussion
  • This procedure is usually indicated for primary angle-closure glaucoma, secondary angle-closure glaucoma, and occluded angle glaucoma.
  • The creation of a new communication or channel for aqueous chamber is the basic goal of the procedure.
  • To relieve the papillary block and reestablish the flow of aqueous through Schlemm’s canal.
Positioning
  • Supine position, slightly elevated or flat.Iridectomy
  • Arms are tucked and with soft restraints.
Drapes/ Packs
  • Ophthalmic packs
  • Special eye fenestrated sheet
  • Basic pack
  • Head or neck pack
Instrumentation
  • Basic eye procedure tray
  • Glaucoma procedure tray
  • Handgrips or drape for microscope
Suppplies/ Equipment
  • Headrest
  • Sitting stool with backrest
  • Microscope or loops
  • Basin set
  • Ophthalmic sponges
  • Blade
  • Multipore filter
  • Cautery
  • Balanced saline solution
  • Medication
  • Sutures
Procedure
  1. A small periotomy (2 mm) is made at the superior limbus.
  2. The epithelium is scraped away from the corneoscleral junction.
  3. Preplaced sutures are placed in the cornea.
  4. Prolapse of the iris is facilitated by gentle traction of the sutures.
  5. The iris is grasped, and the excision is performed.
  6. Balanced saline solution is used to flush away the remaining pigmented epithelium.
  7. The preplaced sutures are tied. Additional sutures may be necessary.
  8. Topical corticosteroids and antibiotic ointment may be instilled, and an eye pad is applied.
Perioperative Nursing Considerations
  1. Patient education is important, since the majority of patient’s will recuperate at home without the aid of direct nursing supervision.
  2. Written materials, audiovisual presentations, and formal education sessions in which questions and / or concerns can be addressed will alleviate anxiety associated with surgical event.
  3. Allow the nurse to strengthen any postoperative instruction for the patient and family.
  4. The patient should be well informed about the specific agents prescribed during the recovery period and notify the physician concerning any problems associated with the agents.
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