Basal iridectomy is a surgical procedure to equalize the intraocular pressure. The procedure is used in cases of glaucoma, for example, to prevent an acute attack of glaucoma. It is a form of surgical treatment for glaucoma.
During a basal iridectomy, the surgeon creates a small hole in the iris of the eye. This allows the exchange of aqueous humor between the anterior and posterior chambers of the eye .
The anterior chamber of the eye can deepen again and release the aqueous humor. The intraocular pressure regulates itself automatically and the pressure on the sensitive optic nerve at the back of the eye decreases.
Intraocular pressure is necessary to maintain the shape of the eye and the distances between the cornea, lens and retina. The pressure is caused by aqueous humor in the eye.
The fluid is produced in the posterior chamber of the eye (between the lens and vitreous body). It enters the anterior chamber of the eye via a space between the iris and the crystalline lens. It washes around the lens of the eye and supplies it with nutrients. The mucus canal in the anterior chamber of the eye finally drains the aqueous humor from the eye.
The structure of the human eye @bilderzwerg/AdobeStock
The production of aqueous humor increases intraocular pressure, while the outflow of aqueous humor lowers intraocular pressure. Normally, intraocular pressure regulates itself.
If more aqueous humor is produced than flows out, the intraocular pressure increases steadily. Natural regulation no longer works, for example due to
Excessive intraocular pressure can lead to damage to the optic nerve at the retina. Visual performance is permanently impaired (see glaucoma).
An iridectomy makes sense if access to the posterior chamber of the eye is necessary from a medical point of view.
This is the case when:
The word iridectomy is derived from the Greek and refers to the "cutting out of the iris". The first such procedures were performed in the 19th century. The doctor made a 4-6 mm incision/penetration at the edge of the cornea. He inserted a small pair of tweezers into the anterior chamber of the eye through this opening.
He grasped the iris at the edge of the pupil and then pulled it out of the opening. He then cut it off with scissors. This often resulted in severe eye injuries or scarring on the iris. These then made it difficult for the patient to see.
Today, a laser is used for this procedure (laser iridotomy). The doctor does not have to open the eye for this. The laser method is now very common because it is much gentler.
Basal iridectomy tends to be used in exceptional cases. For example, laser iridotomy requires a clear cornea. If the cornea is very cloudy, a surgical iridectomy is necessary.
Some doctors prefer basal iridectomy because the surgical hole in the iris is larger than the one made by laser.
A basal iridectomy is always preceded by a number of examinations. The ophthalmologist only prescribes a specific treatment once an exact diagnosis has been made.
Depending on the symptoms, the following examinations may be necessary:
If the findings indicate that access from the anterior to the posterior chamber of the eye is necessary, the doctor will order a basal iridectomy/iridotomy.
The ophthalmologist will explain to the patient exactly what precautions they need to take before the operation. The patient must adhere strictly to these instructions.
Possible measures include
Basal iridectomy is a low-risk surgical procedure that only takes a few minutes. It is usually performed on an outpatient basis in the operating room under local anesthesia. If the patient wishes to have a general anesthetic, they must pay for this themselves.
The patient lies on their back and is given a local anaesthetic. Using a microscope, the surgeon makes a small incision in the cornea to gain access to the anterior chamber of the eye.
Here he cuts out a small section of the iris. This creates a connection between the eye chambers. The outflow of aqueous humor from the posterior to the anterior chamber of the eye is possible again.
Transparent cornea, with the iris behind it @ Adrian /AdobeStock
Normally, no further treatment is necessary after the procedure. The opening in the cornea usually heals within a few weeks without discomfort or pain.
You should note the following immediately after the procedure
In the days following the operation, you should
As the procedure opens the eyeball, complications can arise in rare cases, such as
However, these after-effects usually subside within a few days of the procedure. Overall, side effects are relatively rare with basal iridectomy.
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