‘Pleateau iris’ is a type of predisposition for angle closure where the block is at the level of the ciliary body due to the abnormal ciliary body and subsequent iris position . Plateau iris configuration has the risk to induce high IOP and when untreated can lead to glaucomatous optic damage and irreversible visual loss. Laser procedures can be performed as treatment in initial cases. In Surgical methods, iridoplasty or pupilloplasty involves the mechanical pulling of the iris away from the angle and keeps the iris position using non absorbable sutures and thereby maintains the angle open. Single pass four throw pupilloplasty is a novel method of pupilloplasty where single anterior chamber pass through the cornea followed by four throws are performed to make tight knot in the iris. This pulls the iris away from the angle and changes the vector. The video demonstrates the mechanism of plateau iris and the utility of pupilloplasty in plateau iris management.
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