Indian Journal of Ophthalmology (Jan 2024)

Comparison of cosmesis, mydriasis, fundus visibility, and anterior chamber depth following single-pass four-throw pupilloplasty in congenital and traumatic iris defects

  • S P Singh,
  • Shweta Gupta,
  • Aparajita Chaudhary,
  • Kshama Dwivedi,
  • Vinod K Singh,
  • Shivangi Singh

DOI
https://doi.org/10.4103/IJO.IJO_375_23
Journal volume & issue
Vol. 72, no. 4
pp. 565 – 570

Abstract

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Purpose: To compare postoperative cosmesis, mydriasis, fundus visibility, and anterior chamber depth (ACD) in congenital and traumatic iris defects after single-pass four-throw pupilloplasty (SFTP). Settings and Design: Hospital-based non-randomized interventional study. Methods: SFTP was done along with phacoemulsification in six patients each with congenital and traumatic iris defects, and the patients were followed for a minimum period of 3 months. The postoperative pupil shape, size, mydriasis, and ACD were compared between the two groups. Results: Tissue approximation was successful in 11 out of 12 patients (91.7%), whereas it failed to do so in one patient with traumatic iris tear (8.3%). A central round pupil was attained in all six patients with congenital defects (group 1), whereas in the traumatic group (group 2), a central round pupil was attained in four cases. Group 1 did not show a significant reduction in horizontal pupil diameter, but group 2 had a significant reduction in pupil diameter postoperatively. Mydriasis and fundus visibility were satisfactory in all cases. There was a significant deepening of ACD in both groups. Conclusion: Traumatic mydriasis usually requires SFTP at two opposite poles to achieve a central pupil with a significant reduction in pupil size, whereas congenital coloboma requires SFTP to be done at the site of coloboma with occasional enlargement at the opposite pole if the pupil is eccentric.

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