SIEPSER SLIDING SLIP KNOT

What a tongue twister, the Siepser Sliding Slip knot.  The Siepser Sliding Slip Knot is a procedure that allows more sutures to be added in any meridian of the defect without over tensioning the iris. Dr. Siepser was confident in his technique that he could use it on hundreds of patients. Although it took the Doctor a while to start repairing the iris in a phakic eye, he soon gained all the confidence he needed and was able to repair an iris defect in any meridian. The fact that even today closing iris defects in phakic eyes is not accepted is discouraging. It is important the patients find surgeons that are willing to perform these procedures.  Too many people suffer because doctors tell them “nothing can be done.”The first procedure of an iris defect that was performed on a phakic patient by Dr. Siepser was 20 years ago. He used it on an 18 year old girl whom was struck in the left eye with a fire poker.  That caused a traumatic iris coloboma.  She returned from Denver to have her cataract removed, her sutures cut through her iris over 2 decades. The iris repair surgery was a life changing experience for her. She even ventured out more, moved to Colorado and started snowboarding. Dr. David Chang was the first to bring out the technique of the Siepser Sliding Slip Knot for suture tying in the eye. Dr. Chang was bestowed a traumatic cataract with a gaping iris defect and first used the slip knot with a heavy string.  It was successful and his video of his exceptional work was shown at the University of California – San Francisco alumni meeting. Seeing the Sliding knot for the first time is always an incredible experience.

Phakic- intraocular lens (PIOL) is a special kind of intraocular lens that is implanted surgically into the eye to correct myopia (nearsightedness). It is called “phakic” (meaning “having a lens”) because the eye’s natural lens is left untouched.

Coloboma -is a hole in one of the structures of the eye, such as the iris, retina, choroid, or optic disc.

Zaina Al-Mulhouse SBS Ike Ahmed Garry condon. Suture giants in ophthalmology.
Course on siepser sliding knot. ASCRS. SAN SIEGO 2019