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    Different Approaches To Surgical: Pupilloplasty

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    Mohamed Chekraoui
    Three surgical approaches for pupilloplasty are described to correct traumatic and congenital pupil abnormalities. Suture repair is shown to be an economical option to reshape the pupil using iris stroma. McCannel-like sutures are used to decrease pupil size in one case. For a child with persistent pupillary membrane, membrane removal created a normal centered pupil. All cases demonstrated good functional and aesthetic outcomes with improved vision and reduced glare and photophobia after pupilloplasty.

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    Different Approaches To Surgical: Pupilloplasty

    Uploaded by

    Mohamed Chekraoui
    215 views6 pages
    Three surgical approaches for pupilloplasty are described to correct traumatic and congenital pupil abnormalities. Suture repair is shown to be an economical option to reshape the pupil using iris stroma. McCannel-like sutures are used to decrease pupil size in one case. For a child with persistent pupillary membrane, membrane removal created a normal centered pupil. All cases demonstrated good functional and aesthetic outcomes with improved vision and reduced glare and photophobia after pupilloplasty.

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    Pupiloplastia

    Original Title

    Pupiloplastia Milão

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    Three surgical approaches for pupilloplasty are described to correct traumatic and congenital pupil abnormalities. Suture repair is shown to be an economical option to reshape the pupil using iris stroma. McCannel-like sutures are used to decrease pupil size in one case. For a child with persistent pupillary membrane, membrane removal created a normal centered pupil. All cases demonstrated good functional and aesthetic outcomes with improved vision and reduced glare and photophobia after pupilloplasty.

    Copyright:

    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd
    Download as pdf or txt
    215 views6 pages

    Different Approaches To Surgical: Pupilloplasty

    Uploaded by

    Mohamed Chekraoui
    Three surgical approaches for pupilloplasty are described to correct traumatic and congenital pupil abnormalities. Suture repair is shown to be an economical option to reshape the pupil using iris stroma. McCannel-like sutures are used to decrease pupil size in one case. For a child with persistent pupillary membrane, membrane removal created a normal centered pupil. All cases demonstrated good functional and aesthetic outcomes with improved vision and reduced glare and photophobia after pupilloplasty.

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    Different approaches to surgical

    Pupilloplasty

    Pina S, Pedrosa C, Azevedo A R, Ramalho M, Pgo P, Feijo B, Prieto I


    Ophthalmology Department Hospital Prof. Doutor Fernando Fonseca E.P.E.
    Amadora Lisboa , Portugal
    Head of Department: Dr. Antnio Melo

    The autors have no Financial Disclosure

    SURGICAL PUPILLOPLASTY

    DIFFERENT APROACHES

    Patients with pupil abnormalities, whether from congenital, traumatic or


    other causes, suffer from varying amounts of visual disability, including
    reduced visual acuity, glare and photofobia
    In addition, significant cosmetic issues may also be present
    When we have enough tissue, iris stroma can be stretched and handled to
    create a new pupillary aperture. Suture repair is an economical and promptly
    available surgical option.

    To describe three different minimal invasive surgical approaches to correct


    traumatic and congenital pupil abnormalities

    SURGICAL PUPILLOPLASTY

    DIFFERENT APROACHES

    - 26 years old
    - Penetrant Keratoplasty OD 8 years before
    - Traumatic aphakia, pupillary distortion with iridodialysis and parcial iris loss OD
    - Low vision (20/80 OD)
    - Photofobia and glare

    OD

    Before

    10-0 polypropylene suture &


    double long straight needle

    Pupilloplasty was
    performed with several iris
    sutures in order to create a
    central pupil, giving
    support to an anterior
    chamber
    Iris-Claw IOL

    OD

    After

    Final BCVA: 20/32


    Less glare and photofobia
    Good aesthetic outcome

    SURGICAL PUPILLOPLASTY

    DIFFERENT APROACHES

    - 35 years old
    - Pseudophakia OS
    - Postraumatic mydriasis OS
    - Reduced visual acuity (20/32) OS
    - Photofobia and glare

    OS

    Before

    10-0 polypropylene suture &


    double long straight needle

    OS

    McCannel-like imbricating sutures


    with a Siepser slipknot was used
    and passed at
    3 and 9 oclock
    to decrease pupil size

    After

    Final BCVA: 20/20


    Less glare and photofobia
    Good aesthetic outcome

    SURGICAL PUPILLOPLASTY

    DIFFERENT APROACHES

    3 months old child


    Absence of pupil due to extensive persistent pupillary membrane OS
    OD normal
    Systemic work-up - normal

    OD

    Before

    OD

    Membrane removal
    creating a normal and
    centered pupil
    After
    3 months later

    Excellent
    aesthetic and
    functional outcome

    SURGICAL PUPILLOPLASTY

    DIFFERENT APROACHES

    Traumatic and congenital pupil abnormalities are relatively common problems that can
    be addressed by a simple, economical and readily available pupilloplasty, without the
    need of iris prosthesis

    Pupilloplasty may improve visual outcome, reducing glare disability and photofobia

    This minimal invasive surgery showed to be a good option to correct pupil defects with
    good functional and cosmetic outcome.

    1. Arundhati A, et al, Iris reconstruction in penetrant keratoplasty- surgical techniques and a case-control study to evaluate effect on graft
    survival, Am J Ophthalmol 2008; 145:203-209
    2. Blackmon D M, et al, Congenital iris coloboma repair using a modified McCannel suture technique, Am J Ophthalmol 2003,, 135:730732
    3. Chang D F, Siepser slipknot for McCannel iris-suture fixation of subluxated intraocular lenses, J Cataract Refract Surg 2004, 30:11701176
    4. De Silva, S, et al, Iris-claw intraocular lenses to correct aphakia in the absence of capsule support, J Cataract Refract Surg 2011,
    37:1667-1672

    E-mail: [email protected]

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