Eckardt C, Utermann D
Klin Monbl Augenheilkd. 1986 Feb;188(2):118-21. doi: 10.1055/s-2008-1050593.
During vitreoretinal surgery 14 aphakic patients with complicated retinal detachment were treated with 2 new techniques for surgical dilatation of a miotic and rigid pupil. In 4 cases, iris excision was not performed in the upper part of the pars pupillaris, as usual, but in the lower part. As a result, peripheral anterior synechiae due to silicone oil injection did not occur postoperatively. In the other 10 cases the pupil was temporarily stretched during the operation with 4 iris loop sutures. These sutures were laid in such a way that a retraction of the iris in the main directions of the 4 quadrants was made possible, thereby forming a large square pupil. Postoperatively, no iris damage was found in those cases where miosis had only developed during surgery. In the case of a preoperatively miotic and rigid pupil, stretching caused multiple small sphincter tears in most cases. A few weeks after surgery these patients again showed constriction of the pupil. Their pupils reacted to light, miotics, and mydriatics, but reactions were diminished.
在玻璃体视网膜手术中，对14例伴有复杂性视网膜脱离的无晶状体患者采用了两种新的手术方法来扩大缩瞳且僵硬的瞳孔。4例患者，不像往常那样在瞳孔区上部进行虹膜切除术，而是在下部进行。结果，术后未出现因硅油注入导致的周边前粘连。另外10例患者在手术中用4根虹膜环缝线暂时拉伸瞳孔。这些缝线的放置方式使得虹膜在四个象限的主要方向上能够回缩，从而形成一个大的方形瞳孔。术后，在那些仅在手术过程中出现瞳孔缩小的病例中未发现虹膜损伤。在术前瞳孔就缩小且僵硬的病例中，拉伸在大多数情况下导致了多个小的括约肌撕裂。术后几周，这些患者的瞳孔再次出现收缩。他们的瞳孔对光、缩瞳剂和散瞳剂有反应，但反应减弱。
