Pupil cerclage technique for treatment of traumatic mydriasis
Session Details
Session Title: Paediatric Ophthalmology & Other Topics
Session Date/Time: Tuesday 25/09/2018 | 08:00-10:30
Paper Time: 10:00
Venue: Room A3, Podium 2
First Author: : R.Frisina ITALY
Co Author(s): : E. Midena
Abstract Details
Purpose:
To evaluate the efficacy of pupil cerclage technique for repairing traumatic midryasis.
Setting:
A series of consecutive patients affected by permanent mydriasis secondary to ocular trauma were recruited during first aid outpatient activity of the ophthalmological department of the Univesity of Padua, Italy. Pupil cerclage was proposed for treating permanent mydriasis in combination with other surgical procedures necessary (vitrectomy, cataract surgery).
Methods:
Pupil cerclage and iris repair with a new variant of sliding knot technique combined with vitrectomy and cataract surgery were performed. Baseline best corrected visual acuity (BCVA) and postoperative BCVA at 1st, 3rd, 6st and 12ve month were measured. Intraocular pressure (IOP) was evaluated before and at 1st, 3rd, 6st and 12ve month. Ultrasound biomicroscopy, optical coherence tomography and non-contact anterior segment Scheimplflug imaging were used to evaluate pupil size, anterior chamber angle and the distance from the pupil edge and the lens. In the postoperative follow up the incidence of cystoid macular edema and glaucoma was evaluated.
Results:
Twelve consecutive patients were recruited. The mean age was 49.83±27.44 years. Six patients had a blunt trauma and 6 patients penetrating trauma, 1 with foreign body.
Vitrectomy was performed in 9 cases, in 2 cases with silicon oil for treating retinal detachment. BCVA improved in all cases. Pupil size mean after pupilloplasty was 2.8±0.5 mm. All patients developed temporary cystoid macular edema (CME). The time of onset of CME ranged from 1 to 3 months after surgery. CME disappeared after 2 months. Two patients developed glaucoma well controlled with topical drogs.
Conclusions:
Pupil cerclage technique for repair permanent midryasis reestablishes the pupil with a precise regulation of the pupil diameter and without distortion of its natural round shape. Sliding knot allows surgeon to reduce the risk of iatrogenic iris damage and to make a security knot permanent over time.
Financial Disclosure:
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