Pupillary stretching. A new procedure in vitreous surgery.

During vitreoretinal procedure, 26 aphakic eyes with proliferative vitreoretinopathy and diabetic traction retinal detachment were treated with a new technique for surgical dilatation of a miotic immobile pupil. Four iris loop sutures were laid in such a way that stretching of the pupil in the main directions of the four quadrants was made possible, thus forming a large, square pupil. No functional iris lesion was caused in nine eyes that developed miosis only during surgery. The other 15 eyes already had a miotic and rigid pupil preoperatively. In all but one of these cases, the stretching caused multiple small sphincter tears. The pupils remained partially dilated, but showed a reaction to miotics and mydriatics.