The Chennai city-based doctors have carried out an innovative technique called ‘pinhole pupilloplasty’ which is aimed to correct the vision of patients with astigmatism. The doctors have sutured up the iris, the coloured part of the eye to reduce the size of the pupil to a pinhole. The technique has helped ten people with astigmatism, a refractive power in one direction that distorts an image, to read without glasses.
Dr Amar Agarwal, Chairman of Agarwal Eye Hospitals said that they developed the surgical technique since the expensive eye lens were not helping the scores of patients with corneal damage see clearly despite corneal transplant.

“Six months ago, we had a 67-year-old patient left with scarred cornea due to some complications after a corneal transplant. His astigmatism (power) was 20 diopters which made everything around him look hazy. A group of doctors in my team wanted a repeat transplant, but others weren’t keen because the patient will still have the refractive mirror. It was the crude pinhole camera that offered them a solution. Opticians use this pinhole lens to diagnose refractive errors” he added.
But the doctors were not sure about the theory until they operated on the first patient, though it was logical. That patient was able to read two days after the surgery. When they found the results positive, the hospital suggested a similar surgery for 67-year-old J Bhaskaran immediately. “We removed the glass but when he complained of distorted vision, we took him up for the pinhole pupilloplasty. He can now see clearly,” hospital consultant Dr Soundari said.
After the success, the hospital has done eight more similar surgeries. They have also presented the cases at a recent conference in Europe. Sadath Ali, who developed refractive error after corneal transplant said, My vision has never been better,”
Pinhole intraocular lenses – coloured lens with a pinhole -are commercially available in some parts of the world, though not in India. So, the idea of suturing the iris is new but leaving a pinhole in the pupil to sharpen isn’t.

Image: Times of India
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