Pupilloplasty

[vmounce]

I need help with this please. Thanks in advance.

Vickie

PREOPERATIVE DIAGNOSIS: Pupillary-wound incarceration, OD.

POSTOPERATIVE DIAGNOSIS: Pupillary-wound incarceration, OD.

PROCEDURE: Not dictated.

OPERATIVE PROCEDURE: After obtaining informed consent, the patient was taken to the operating room and placed on the operating room table in the supine position. Peripheral IV and nasal oxygen cannula was administered to the patient and continued throughout the procedure. Electrocardiogram electrodes, blood pressure cuff, and pulse oximetry were placed on the patient for monitoring purposes. Tetracaine drops were instilled. Corneal drops of 5% Betadine were administered. The patient was then prepped and draped in the usual sterile fashion using Betadine paint and soap.

Two Newell lid speculums were placed. A 15-degree stab blade was used to make a narrow paracentesis in the anterior chamber at the superomedial limbus. 0.2 cc of sugarcane mixture was injected through the paracentesis. An iris sweep was then used to attempt to break the adhesions between the pupillary border and the previously placed temporal wound. This was unsuccessful. A small amount of Healon solution was injected into the anterior chamber. Retinal scissors were introduced through the superior nasal paracentesis and the adhesions between the iris and cornea were engaged and dissected. The pupil returned to its normal round configuration.

The viscoelastic was removed using BSS irrigation. Miostat solution was then injected and the pupil constricted nicely in a round fashion.