Clinical Outcome Of Iris-Circlage Pupilloplasty In Persistent Mydriasis : Case Series
Published 2025 - 43rd Congress of the ESCRS
Reference: PO1019 | Type: Poster | DOI: 10.82333/ksa7-4239
Authors: Ga Hye Lee* 1 , Man Ji 1 , Mee Kum Kim 2
1Laboratory of Ocular Regenerative Medicine and Immunology,Biomedical Research Institute, Seoul National University Hospital,Seoul,Korea, Republic Of;Department of Ophthalmology,Seoul National University College of Medicine,Seoul,Korea, Republic Of, 2Department of Ophthalmology,Seoul National University College of Medicine,Seoul,Korea, Republic Of;Laboratory of Ocular Regenerative Medicine and Immunology,Biomedical Research Institute, Seoul National University Hospital,Seoul,Korea, Republic Of;Transplantation Research Institute,Seoul National University Medical Research Center,Seoul,Korea, Republic Of
Purpose
This study aims to evaluate the clinical outcomes and long-term stability of iris-cerclage pupilloplasty in patients with persistent mydriasis.
Setting
This retrospective case series included seven patients who underwent iris-cerclage pupilloplasty for persistent mydriasis at Seoul National University Hospital, Seoul, South Korea, between September 2011 and June 2024. The average follow-up period was 55 months.
Methods
Iris-cerclage pupilloplasty was performed on 7 patients with persistently dilated pupils. Among 7 eyes, mydriasis was caused by angle closure glaucoma in 4 cases and trauma in 3 cases. In two cases with pre-existing corneal edema, Descemet membrane endothelial keratoplasty (DMEK) was performed along with pupilloplasty. Visual acuity, central corneal thickness, endothelial cell density, glare, presence of complications were assessed. The horizontal pupil diameter was measured pre- and post-operatively using Placido disc-based topography (Carl Zeiss Meditech, Dublin, CA, USA). The relative pupil area based on corneal size was calculated and compared between the pre- and post-operative size using Image J software.
Results
The average horizontal pupil diameter decreased from 6.11mm preoperatively to 3.0mm postoperatively. The postoperative pupil area decreased by an average of 80.6% compared to the preoperative area. The average best-corrected visual acuity improved from 0.80 logMAR preoperatively to 0.11 logMAR postoperatively. The mean endothelial cell density decreased by 1.9%, and no corneal edema was observed. In an eye with a one-hour of ciliary body detachment intraoperatively, the intraocular pressure remained unchanged. Suture-related depigmentation was mostly observed at the average of 7 month, but the pupil suture remained intact until the last follow-up.
Conclusions
This study demonstrates that Iris-cerclage pupilloplasty in eyes with persistently dilated pupils shows a high success rate and long-term stability, making it an effective surgical method for managing persistent pupillary dilation.