Iris injuries can be very disabling due to the dramatic light sensitivity and cosmetic problems that they cause. Repairing these injuries is challenging and therefore very few ophthalmologists perform this work. The key to achieving an excellent result is a delicate touch and a highly rehearsed technique.

Iris injuries can be repaired with either iris suturing (pupilloplasty) or artificial iris implants (iris prostheses). The iris implants available in Australia are the Morcher aniridic iris segments, the Human Optics iris implants, and the Ophtec artificial iris implants.

Gold Coast eye surgeon performing iris surgery with iris prosthesis
Gold Coast eye surgeon performing iris surgery with iris prosthesis

Dr Andrew is fortunate to have been fellowship trained by the global leader in iris repair surgery, Dr Ike Ahmed. As such, Dr Andrew is experienced with all techniques for iris repair.

There are numerous surgical techniques for repairing iris defects and each has its specific advantages and considerations.  Having first hand experience with each technique improves patient outcomes.

Whenever possible, Dr Andrew will repair your iris and pupil with sutures. The suture used is 10-0 Prolene, one of the finest sutures manufactured, and much finer than a human hair. Dr Andrew performs pupil cerclage iris suturing, and iris repair with interrupted sutures. He performs the surgery with intraocular microinstruments and McAhmed suture knots, Seipser knots, and intraocular tying.

When there is insufficient iris tissue remaining, an iris prosthesis will be required. These can be made bespoke to match the colour of your fellow eye. Note that iris implants are only used to repair an iris injury – it is not appropriate to implant them for cosmetic reasons to change the colour of your eyes.

Fortunately, the results of iris repair operations can be truly stunning, which makes this line of work very satisfying.

Human Optics artificial iris prosthesis to repair iris trauma injury in Gold Coast Australia

Human Optics Artificial Iris Implants

This is an artificial iris prosthesis made by HumanOptics. Each implant is hand crafted in Germany to precisely match the colour and detail of the fellow (normal) iris. High resolution images of the normal iris are sent to HumanOptics and an identical prosthesis is manufactured and shipped within 6 weeks. Read more about HumanOptics artificial iris implants here. Photograph courtesy of HumanOptics.

Human Optics artificial iris prosthesis to repair iris trauma injury in Gold Coast Australia

Morcher Artificial Iris Implants

The iris implants by Morcher are made from black PMMA, which is a rigid plastic. Multiple Morcher implants can be overlapped to achieve complete coverage of the iris defect. They are effective at blocking stray light and reducing glare symptoms, but they do not improve the cosmetic appearance of your iris and pupil. They are a reasonable option for patients with darkly coloured eyes, but they are not a cosmetically acceptable solution for patients with light iris colour.

Dr Andrew’s Surgical Results

Human Optics artificial iris prosthesis to repair iris trauma injury in Gold Coast Australia

The patient above suffered a right eye dilated pupil and cataract following eye trauma. Dr Andrew repaired this injury with cataract surgery, a Morcher aniridic iris implant, and iris cerclage pupilloplasty (iris suturing).

Human Optics artificial iris prosthesis to repair iris trauma injury in Gold Coast Australia

The photograph above shows the post-operative appearance of a patient who has undergone bilateral iris cerclage pupilloplasty (iris suturing) with Dr Andrew. This operation acts like a purse string to permanently reduce the pupil size. In this patient, the operation was required to improve the clarity of their vision following complications of previous eye surgery (performed elsewhere).

Human Optics artificial iris prosthesis to repair iris trauma injury in Gold Coast Australia

The photo above shows the appearance of an eye following an iris cerclage pupilloplasty performed by Dr Andrew. A suture has been woven around the pupil margin to reduce the pupil size, like a purse string. The suture material that Dr Andrew uses is so fine that it is not visible in this patient, even on a high magnification photograph.

Human Optics artificial iris prosthesis to repair iris trauma injury in Gold Coast Australia

The photo above shows the appearance of an eye following an iris cerclage pupilloplasty performed by Dr Andrew. This patient’s pupil was permanently dilated following surgical trauma, causing the patient to suffer severe light sensitivity and blurred vision. Dr Andrew’s operation reduced the pupil back to a normal size whilst also improving the appearance of the patient’s eye.

Dislocated cataract

Repair of iris injury with iris cerclage pupilloplasty in Australia by Dr Nick Andrew

Left: dislocated cataract and dilated irregular pupil following trauma.

Right: The immediate post-op appearance following cataract surgery using Morcher capsule hooks, capsular tension ring, and iris cerclage pupilloplasty (iris suturing).

Irregular pupil

Iris surgery with iris suturing usig pupil cerclage pupilloplasty.

Left: Cataract and dilated irregular pupil following an acute angle closure glaucoma attack.

Right: The immediate post-op appearance following cataract surgery, minimally-invasive glaucoma surgery using iStents, and pupilloplasty (iris suturing) with adjunctive iris cautery. In addition, I performed goniosynechiolysis to remove adhesions of iris from the drainage channels and endocyclophotogonioplasty (endoscopic laser probe) to widen the patient’s narrow drainage angle. The pigmented areas around the pupil margin fade post-op.

Dr Andrew is an eye surgeon with particular expertise in:

  • Iris surgery and iris repair including iris prostheses
  • Intraocular lens (IOL) exchanges
  • Dislocated lenses (including dislocated cataracts)

Each surgical technique has its own advantages and considerations. The specific operation recommended for you will depend on your situation.

Dr Andrew was trained by the highly esteemed Dr Ike Ahmed in Toronto, who, in 2020, was ranked as the second most highly rated ophthalmologist in the world.  Dr Andrew undertook the prestigious GAASS Fellowship in Toronto with Dr Ahmed.

What are the risks of iris surgery?

Below are the main risks that relate specifically to iris surgery. Note that there are other, rarer complications than this. All risks will be discussed with you as a part of your consultation with Dr Andrew.

  • Persistent light sensitivity or glare. This can result from stray rays of light passing through areas of iris that are abnormally thin. This is rarely a persistent problem, but if so, it can usually be addressed with another operation.
  • Asymmetry in pupil size, pupil position, pupil shape or iris appearance. The aim is to produce a pupil that is round, centred, and approximately equal in size to the fellow pupil in indoor lighting conditions. However, sometimes it is impossible to achieve all of these goals, especially when the iris is abnormally thin, friable (brittle), or has been traumatised previously. The aim is to achieve the best cosmetic and functional result possible for the iris tissue that you have.
  • Reduced ability for eye doctors to examine the far peripheral retina (this only applies to iris surgeries where the pupil size is made smaller). This is very rarely a problem. However, if it was medically essential to examine the far peripheral retina then the iris suture could be cut with a laser.
  • Reduced vision in dim lighting (this only applies to iris surgeries where the pupil size is made smaller). By making the pupil smaller, less light can enter the eye. This reduces glare symptoms, but may cause a reduction in the brightness of vision in dim lighting. This is rarely noticeable if the eye is otherwise healthy.

NOTE: ALL SURGICAL PROCEDURES CARRY RISK. BEFORE PROCEDING WITH ANY OPERATION, ALWAYS CONSIDER OBTAINING A SECOND OPINION FROM AN APPROPRIATELY QUALIFIED HEALTH PRACTITIONER.

Opening hours

Monday to Friday: 8am – 4.30pm

Dr Nick Andrew, Ophthalmologist and Eye Surgeon

Sight Specialists, Level 2, 95 Nerang St, Southport QLD 4215

Medical disclaimer

The content provided on this website is for educational purposes only. It is not intended to provide medical advice or to take the place of such advice or treatment from a personal physician.

All readers/viewers of this content are advised to consult their doctors or qualified health professionals regarding specific health questions.

Neither Dr. Andrew nor the publisher of this content takes responsibility for possible health consequences of any person or persons reading or following the information in this educational content.