Pupillary Circlage: Repairing the Permanently Dilated Traumatic Pupil During Cataract Surgery

Dr. Carlson

There are a number of potential injuries that can occur to the eye producing the permanently dilated pupil.  Infection, angle closure glaucoma, previous surgery, and blunt trauma can all produce this problem.  The permanently dilated pupil is more likely to produce unwanted glare, brightness during the day, and halos around oncoming headlights.  This functional impact may also include a cosmetic problem as well in patients that have a light colored iris  making the problem of anisocoria more apparent. Alan N. Carlson, M.D., Professor of Ophthalmology and Chief of the Corneal and Refractive Surgery Service at the Duke Eye Center in Durham, NC, specializes in complex cataract surgery that includes preventing and repairing surgical complications.  Today’s blog covers the simultaneous repair of a permanently dilated pupil in a patient who developed a visually significant cataract following blunt trauma and previous glaucoma surgery consisting of a tube shunt.  A key issue with respect to iris repair includes assessing for iris atrophy which can limit the ability your ability to further manipulate the iris and produce suture-related traction on the iris without leading to a “cheese-wire” effect over time.  Fortunately, this patient did amazingly well from a desired functional as well as cosmetic standpoint!

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