Different approaches to surgical pupilloplasty

Pina, S; Pedrosa, C; Azevedo, A; Ramalho, M; Pêgo, P; Feijóo, B; Prieto, I

http://hdl.handle.net/10400.10/808

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Abstract(s)

Purpose: To describe three different minimal invasive surgical approaches for correction of traumatic and congenital pupil abnormalities. Setting/Venue: Ophthalmology Department, Prof Dr. Fernando Fonseca Hospital EPE. Amadora, Lisboa, Portugal Methods: We describe three clinical cases with pupil abnormalities from different ethiology, all submitted to pupiloplasty in order to improve visual and aesthetic outcome. First patient presented a traumatic aphakia and ectopic pupil in his right eye. Pupiloplasty was performed with several iris sutures in order to create a central pupil, giving support to anterior chamber Iris-Claw IOL. Second patient presented with a postraumatic mydriasis of the left eye. In this case a McCannel-like imbricating suture with Siepser knot was used and passed at 3 and 9 o´clock to decrease the pupil size. In these 2 cases we used a 10-0 polypropilene suture. Last patient, a 3-months-old child, presented absence of pupil due to total persistence of pupilary membrane in her left eye and was submitted to the membrane removal creating a normal and centered pupil. Patient workup included anterior segment photographs before and after surgery. We present the surgery videos. Results: All patients showed an acceptable pupil shape and position after surgical procedures that provided a good functional and cosmetic results. Conclusions: Traumatic and congenital pupil abnormalities are relatively common problems that can be addressed by a simple pupiloplasty, without the need of iris prostheses. Pupiloplasty 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 esthetic outcome.