The iris can be sutured, typically using 10-0 polypropylene, to help restore the pupil anatomy in cases of iris trauma. This iris damage can be from accidental trauma or from iatrogenic causes, like the case shown here. This is more common in patients with floppy iris syndrome and can occur at the time of cataract surgery. We have featured other pupilloplasty cases here on CataractCoach and the principles are consistent: get a sufficient bite of iris tissue, avoid the ischemic areas, and plan on a 3.5 to 4 mm diameter pupil in order to preserve the ability to examine the retina.

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