Purpose: To examine the safety of pupilloplasty with iris suturing by evaluating postoperative results of several patients who underwent this procedure.
Subjects and methods: We examined 26 eyes belonging to 26 patients who underwent pupilloplasty with iris suturing using long needle and be followed up for more than six months at the Showa University Fujigaoka Hospital and Showa University Fujigaoka Rehabilitation Hospital between 2007 and 2021. We retrospectively examined the types and causes of anisocoria before the surgery, the procedure that was followed, and the postoperative course.
Results: The mean patient age was 68.1±13.5 years (mean±standard deviation). The participants included 20 male eyes and 6 female eyes. The mean follow-up period was 32.2±30.0 months. Regarding the iris shape, 15 eyes were classified as having a partial defect, 7 as having iridodialysis, and 5 as having mydriasis. The most common cause of partial defects and iridodialysis was iatrogenic (13 eyes), followed by trauma (7 eyes). The main causes of the mydriasis included trauma (3 eyes) and glaucoma (1 eye). Iris suturing alone was used for 9 eyes, phacoemulsification and iris suturing were used in combination for 9 eyes, intraocular lens implantation and iris suturing were used for 7 eyes, and ciliary body and iris suturing were used in 1 eye. Regarding the suture material, a 9-0 or 10-0 polypropylene suture was used for all patients. The iris shapes showed postoperative improvement in all patients, and subjective symptoms, such as mydriasis-induced photophobia, were alleviated in patients with mydriasis. One intraoperative complication was encountered, wherein a long needle end touched the corneal endothelium, resulting in Descemet membrane detachment, but recovery was spontaneous. The mean rate of corneal endothelial cell loss was 12.5%±15.4%. No suture detachment or chronic inflammation was observed in any of the eyes.
Conclusion: The postoperative course of pupilloplasty with iris suturing was uneventful and it was considered a relatively safe procedure.
Nippon Ganka Gakkai Zasshi (J Jpn Ophthalmol Soc) 126: 689-696, 2022.