Purpose: Pupilloplasty techniques are delicate, especially in phakic patients where the risk of touching the lens with the needle during the procedure is high. We report the case of a phakic patient in whom we used an allogeneic Kerato-lenticule Extraction (KLEx) lenticule temporarily to protect the lens during the procedure.
Observation: This is a 43-year-old male patient with a significant post-traumatic temporal iris defect. The patient complained of permanent discomfort in the form of monocular diplopia and photophobia. Surgery was performed under local anesthesia. The first step was to position a 6.5 mm-diameter, 109 μm-thick KLEx lenticule in front of the crystalline lens. The iris defect was then repaired with greater safety by positioning prolene knots using the Siepser technique. At the end of the procedure, the lenticule was removed from the anterior chamber. Post-operative follow-up confirmed the absence of lens damage, with no cataract at 6 months post-op.
Conclusions and importance: We report here a new technique in pupilloplasty by using a temporary KLEx lenticule as part of the iris repair. We found the procedure much less risky when the needles were passed anterior to the crystalline lens.
Keywords: Clear lens; KLEx; Kerato-lenticule extraction; Phakic eye; Pupilloplasty; SMILE; Small incision lenticule extraction.
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