[Surgical pupillary dilatation within the scope of complicated retinal detachment surgery]

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.