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PMID- 29776352
DCOM- 20180525
LR  - 20180525
IS  - 1471-2415 (Electronic)
IS  - 1471-2415 (Linking)
VI  - 18
IP  - 1
DP  - 2018 May 18
TI  - Surgical peripheral iridectomy via a clear-cornea phacoemulsification incision
      for pupillary block following cataract surgery in acute angle closure.
PG  - 120
LID - 10.1186/s12886-018-0786-2 [doi]
AB  - BACKGROUND: To describe a technique of surgical peripheral iridectomy via a
      clear-cornea tunnel incision to prevent or treat pupillary block following
      phacoemulsification. METHODS: Description of technique and retrospective
      description results in 20 eyes of 20 patients with acute angle closure with
      coexisting visually significant cataract undergoing phacoemulsification
      considered at risk of postoperative papillary block as well as two pseudo-phakic 
      eyes with acute postoperative pupillary-block. Following phacoemulsification and 
      insertion of an intraocular lens, a needle with a bent tip was inserted behind
      the iris through the corneal tunnel incision. A blunt iris repositor was
      introduced through the paracentesis and placed above the iris to exert posterior 
      pressure and create a puncture. The size of the puncture was enlarged using
      scissors. For postoperative pupillary block the same technique was carried out
      through the existing incisions created for phacoemulsification. RESULTS:
      Peripheral iridectomy was successfully created in all 22 eyes. At a mean
      follow-up of 18.77 +/- 9.72 months, none of the iridectomies closed or required
      enlargement. Two eyes had mild intraoperative bleeding and one eye a small
      Descemet's detachment that did not require intervention. No clinically
      significant complications were observed. Visual acuity and IOP improved or was
      maintained in all patients. The incidence of pupillary block in our hospital was 
      0.09% overall, 0.6% in diabetics and 3.5% in those with diabetic retinopathy.
      CONCLUSIONS: This technique of peripheral iridectomy via the cornea tunnel
      incision can be safely used during phacoemulsification in eyes at high risk of
      pupillary block or in the treatment of acute postoperative pupillary-block after 
      cataract surgery. The technique is likely to be especially useful in brown iris, 
      or if a laser is not available.
FAU - Fang, Aiwu
AU  - Fang A
AD  - Wenzhou Medical University Eye Hospital, Wenzhou, 325027, China.
FAU - Wang, Peijuan
AU  - Wang P
AD  - Wenzhou Medical University Eye Hospital, Wenzhou, 325027, China.
FAU - He, Rui
AU  - He R
AD  - Wenzhou Medical University Eye Hospital, Wenzhou, 325027, China.
FAU - Qu, Jia
AU  - Qu J
AD  - Wenzhou Medical University Eye Hospital, Wenzhou, 325027, China. [email protected]
LA  - eng
PT  - Journal Article
DEP - 20180518
PL  - England
TA  - BMC Ophthalmol
JT  - BMC ophthalmology
JID - 100967802
SB  - IM
MH  - Adult
MH  - Aged
MH  - Cataract Extraction/*adverse effects
MH  - Female
MH  - Follow-Up Studies
MH  - Glaucoma, Angle-Closure/surgery
MH  - Humans
MH  - Iridectomy/*methods
MH  - Iris/surgery
MH  - Lens Implantation, Intraocular
MH  - Male
MH  - Middle Aged
MH  - Phacoemulsification/*methods
MH  - Postoperative Complications/*surgery
MH  - Pupil Disorders/*surgery
MH  - Retrospective Studies
MH  - Visual Acuity
PMC - PMC5960131
OT  - Acute angle closure
OT  - Phacoemulsification
OT  - Pupillary block
OT  - Surgical peripheral iridectomy
EDAT- 2018/05/20 06:00
MHDA- 2018/05/26 06:00
CRDT- 2018/05/20 06:00
PHST- 2017/03/26 00:00 [received]
PHST- 2018/05/09 00:00 [accepted]
PHST- 2018/05/20 06:00 [entrez]
PHST- 2018/05/20 06:00 [pubmed]
PHST- 2018/05/26 06:00 [medline]
AID - 10.1186/s12886-018-0786-2 [doi]
AID - 10.1186/s12886-018-0786-2 [pii]
PST - epublish
SO  - BMC Ophthalmol. 2018 May 18;18(1):120. doi: 10.1186/s12886-018-0786-2.