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The Prethreaded Pupillary Dilating (Torpedo) Suture for Phakic and Aphakic Eyes

The Prethreaded Pupillary Dilating (Torpedo) Suture for Phakic and Aphakic Eyes Abstract • A variety of methods for maintaining pupillary dilation for intraocular surgery have been advocated because pharmacologic agents may fail to maintain or adequately dilate the pupil. We have used a threaded needle to rapidly dilate the pupils of 19 aphakic, pseudophakic, or phakic eyes without damaging the lens or pseudophakos. This dilating suture can be constructed from available materials at low cost. We discuss the preparation of the suture and the techniques that allow rapid and reliable dilation during posterior vitrectomy or anterior segment surgery. Histologic studies were performed on rabbit eyes and demonstrated the position of the suture after performing pupillary dilation in phakic eyes. The technique has been used to dilate the pupils of phakic, aphakic, and pseudophakic patients without evidence of clinically significant complications. References 1. Duffin RM, Camras CB, Gardner SK, Pettit TH. Inhibitors of surgically induced miosis . Ophthalmology . 1982;89:966-970.Crossref 2. Stark WJ, Fagadau WR, Stewart RH, et al. Reduction of pupillary constriction during cataract surgery using suprofen . Arch Ophthalmol . 1986;104:364-366.Crossref 3. Vander JF, Greven CM, Maguire JI, Moreno RJ, Shakin EP, Lucier AC. Flurbiprofen sodium to prevent intraoperative miosis during vitreoretinal surgery . Am J Ophthalmol . 1989;108:288-291. 4. Smiddy WE, Glaser BM, Michels RG, Vitale S. Miosis during vitreoretinal surgery . Retina . 1990;10:42-46.Crossref 5. Michels RG, Glaser BM. Surgical treatment of postoperative dilated, nonreactive pupil in eyes after combined pars plana lensectomy and vitrectomy . Retina . 1990;10:205-208.Crossref 6. McCuen BW II, Hickingbotham D, Tsai M, de Juan E Jr. Temporary iris fixation with a micro-iris retractor . Arch Ophthalmol . 1989;107:925-927.Crossref 7. Fuller DG, Wilson DL. Translimbal iris hook for pupillary dilation during vitreous surgery . Am J Ophthalmol . 1990;110:577. 8. Murray TG, Abrams GW. A new self-sealing needle for iris suture fixation . Arch Ophthalmol . 1990;108:746-747.Crossref 9. Eckardt C. Pupillary stretching: a new procedure in vitreous surgery . Retina . 1985;5:235-238.Crossref 10. Federman J, Anand R. Surgical dilation of the pupil during pars plana vitrectomy . Ophthalmic Surg . 1989;20:46-48. 11. Lean JS, Stern WH, Irvine AR, Azen SP. Classification of proliferative vitreoretinopathy used in the silicone study . Ophthalmology . 1989;96:765-771.Crossref 12. Klein EM, Bito LZ. Species variations in the pathophysiologic responses of vertebrate eyes to a chemical irritant, nitrogen mustard . Invest Ophthalmol Vis Sci . 1983;24:184-191. 13. Lubniewski AJ, Holland EJ, Van Meter WS, Gussler D, Parelman J, Smith ME. Histologic study of eyes with transsclerally sutured posterior chamber intraocular lenses . Am J Ophthalmol . 1990;110:237-243. 14. Campo RV, Chung KD, Oyakawa RT. Pars plana vitrectomy in the management of dislocated posterior chamber lenses . Am J Ophthalmol . 1989;108:529-534. 15. Smiddy WE. Dislocated posterior chamber intraocular lens: a new technique of management . Arch Ophthalmol . 1989;107:1678-1680.Crossref http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png Archives of Ophthalmology American Medical Association

The Prethreaded Pupillary Dilating (Torpedo) Suture for Phakic and Aphakic Eyes

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Publisher
American Medical Association
Copyright
Copyright © 1992 American Medical Association. All Rights Reserved.
ISSN
0003-9950
eISSN
1538-3687
DOI
10.1001/archopht.1992.01080160142053
Publisher site
See Article on Publisher Site

Abstract

Abstract • A variety of methods for maintaining pupillary dilation for intraocular surgery have been advocated because pharmacologic agents may fail to maintain or adequately dilate the pupil. We have used a threaded needle to rapidly dilate the pupils of 19 aphakic, pseudophakic, or phakic eyes without damaging the lens or pseudophakos. This dilating suture can be constructed from available materials at low cost. We discuss the preparation of the suture and the techniques that allow rapid and reliable dilation during posterior vitrectomy or anterior segment surgery. Histologic studies were performed on rabbit eyes and demonstrated the position of the suture after performing pupillary dilation in phakic eyes. The technique has been used to dilate the pupils of phakic, aphakic, and pseudophakic patients without evidence of clinically significant complications. References 1. Duffin RM, Camras CB, Gardner SK, Pettit TH. Inhibitors of surgically induced miosis . Ophthalmology . 1982;89:966-970.Crossref 2. Stark WJ, Fagadau WR, Stewart RH, et al. Reduction of pupillary constriction during cataract surgery using suprofen . Arch Ophthalmol . 1986;104:364-366.Crossref 3. Vander JF, Greven CM, Maguire JI, Moreno RJ, Shakin EP, Lucier AC. Flurbiprofen sodium to prevent intraoperative miosis during vitreoretinal surgery . Am J Ophthalmol . 1989;108:288-291. 4. Smiddy WE, Glaser BM, Michels RG, Vitale S. Miosis during vitreoretinal surgery . Retina . 1990;10:42-46.Crossref 5. Michels RG, Glaser BM. Surgical treatment of postoperative dilated, nonreactive pupil in eyes after combined pars plana lensectomy and vitrectomy . Retina . 1990;10:205-208.Crossref 6. McCuen BW II, Hickingbotham D, Tsai M, de Juan E Jr. Temporary iris fixation with a micro-iris retractor . Arch Ophthalmol . 1989;107:925-927.Crossref 7. Fuller DG, Wilson DL. Translimbal iris hook for pupillary dilation during vitreous surgery . Am J Ophthalmol . 1990;110:577. 8. Murray TG, Abrams GW. A new self-sealing needle for iris suture fixation . Arch Ophthalmol . 1990;108:746-747.Crossref 9. Eckardt C. Pupillary stretching: a new procedure in vitreous surgery . Retina . 1985;5:235-238.Crossref 10. Federman J, Anand R. Surgical dilation of the pupil during pars plana vitrectomy . Ophthalmic Surg . 1989;20:46-48. 11. Lean JS, Stern WH, Irvine AR, Azen SP. Classification of proliferative vitreoretinopathy used in the silicone study . Ophthalmology . 1989;96:765-771.Crossref 12. Klein EM, Bito LZ. Species variations in the pathophysiologic responses of vertebrate eyes to a chemical irritant, nitrogen mustard . Invest Ophthalmol Vis Sci . 1983;24:184-191. 13. Lubniewski AJ, Holland EJ, Van Meter WS, Gussler D, Parelman J, Smith ME. Histologic study of eyes with transsclerally sutured posterior chamber intraocular lenses . Am J Ophthalmol . 1990;110:237-243. 14. Campo RV, Chung KD, Oyakawa RT. Pars plana vitrectomy in the management of dislocated posterior chamber lenses . Am J Ophthalmol . 1989;108:529-534. 15. Smiddy WE. Dislocated posterior chamber intraocular lens: a new technique of management . Arch Ophthalmol . 1989;107:1678-1680.Crossref

Journal

Archives of OphthalmologyAmerican Medical Association

Published: Apr 1, 1992

References