SFT: Are You In The Loop?
Single-pass four throw (SFT) and pinhole pupilloplasty is set to become the new standard of care in pupil reconstruction
Amar Agarwal, Priya Narang | | Longer Read
At a Glance
- SFT is an alternative method of pupilloplasty, requiring the surgeon to pass the suture end through the loop four times
- Compared with current pupilloplasty methods, it offers faster visual recovery and reduced postoperative inflammation
- Reconstructing the pupil this way prevents patients from glare, photophobia and untoward images formed due to reflection of light
- PPP with SFT is suitable for patients with a range of visual disorders – from high astigmatism and corneal injuries to post-penetrating keratoplasty.
Single-pass four throw (SFT) pupilloplasty is a relatively new surgical technique (1). It was initially described as a modification of the Siepser’s method, but the knot formation has been found to belong to the Timber Hitch method of tying. In this technique, a 10-0 or a 9-0 polypropylene suture attached to a long arm needle is passed through the proximal iris tissue that is to be involved in the pupil reconstruction. A 26 G needle is introduced from the paracentesis in the opposite direction, where it engages the distal iris tissue to be approximated (Figure 1 A). The 10-0 needle is then passed in to the barrel of the 26 G needle, before it is withdrawn from the eye. A Sinskey’s hook withdraws the loop of the suture (Figure 1 B) and the suture end is passed from the loop four times, thereby taking four throws (Figure 1 C). Both the suture ends are pulled, and the loop slides inside the eye, thereby approximating the pupillary edges together (Figure 1 D). A micro-scissor is introduced inside the eye and the suture ends are cut. The helical structure created due to the loop approximation forms a self-locking and a self-retaining knot inside the eye.
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