Terminological and Metrological Aspects in Siepser-Type Iris Suture Procedures

Abstract

Instead of contemporary plethora, with tenths of different terms for only 7 elements, I suggest a system in which the main criterion is the length of the 2 filament ends just before the loop is externalized: L: long end, and S: short end. The name of the 2 corneal pathways, and 2 iris bites will rely on the name of the corresponding filament end that passes through, just before the loop is externalized: Sp/SP: short-end puncture/paracentesis, Lp/LP: long-end puncture/paracentesis, SIB: short-end iris bite, LIB: long-end iris bite. When the loop is externalized, the “intermediary segment”: (I) is created from L. The limits of (I) have been adjusted: instead of generally admitted limits from the middistance between SIB and LIB, to the middle of the externalized loop, I suggest that the S/(I) limit be situated at 1mm after the exit point of the loop from SP, and the (I)/L limit be situated at the re-entry point of the loop in SP. The suggested terminology and limits of (I) allow a clear and unequivocal description of techniques, simplify the repartition of functions per filament segment, avoid misunderstanding as cause of failure, facilitate the establishment of rules for success valid in any Siepser-type suture, and allow a new systematization of all iris suture procedures in a structure with a common stem, 2 branches (McCannel, Siepser) and leaves represented by technical variants.