Late iris cerclage suture cheese-wiring.

PURPOSE: To describe a case series of cerclage failures due to cheese-wiring; iris repair can develop late cheese-wiring of cerclage sutures with resultant loss of benefits.

SETTING

Cincinnati Eye Institute, Cincinnati, Ohio.

DESIGN

Retrospective single-surgeon case series.

METHODS

A retrospective chart review sought patients who underwent iris cerclage at the Cincinnati Eye Institute who later developed suture cheese-wiring. The patient symptoms, demographics, cerclage size, suture type, knot type, iris status, and suture status at final follow-up were ascertained.

RESULTS

6 cases of cerclage suture cheese-wiring with loss of the original surgical benefit were identified. 10-0 polypropylene suture and a 3-1-1 knot were used in each case. The suture remained intact with an intact knot and suture loop in all cases.

CONCLUSIONS

Cheese-wiring with return of mydriasis is a potential long-term outcome of iris cerclage suture placement, with return of preoperative symptoms. Awareness of this potential eventuality provides physicians and patients a broader perspective when selecting between cerclage suture, iris prosthesis placement, or other surgical and nonsurgical options.