Posterior synechiae after glaucoma operations: aggravation by shallow anterior chamber and pilocarpine

Br J Ophthalmol. 1987 Jun;71(6):428-32. doi: 10.1136/bjo.71.6.428.

Abstract

Posterior pupillary synechiae affect a proportion of eyes subjected to iridectomy with or without drainage operation because (1) aqueous humour bypasses the pupil; (2) traumatic iridocyclitis occurs; (3) there is immobility of the iris in the iridectomy sector; (4) in eyes with angle closure glaucoma closer apposition of the iris to the anterior lens capsule increases the tendency; (5) pilocarpine aggravates (4) both in angle closure glaucoma and open angle glaucoma and produces a small immobile pupil facilitating pupillary membrane formation (occlusio pupillae). Pilocarpine should be avoided if possible as medical treatment at any time after a drainage operation. A beta blocker is the drug of choice. To eliminate posterior synechiae over a fair number of degrees of pupil (say 30 degrees) sector iridectomy can be done.

MeSH terms

  • Aged
  • Anterior Chamber
  • Aqueous Humor / physiology
  • Female
  • Glaucoma / surgery*
  • Humans
  • Iris / surgery
  • Iris Diseases / etiology*
  • Laser Therapy
  • Lens Capsule, Crystalline
  • Lens Diseases / etiology
  • Male
  • Pilocarpine / adverse effects*
  • Postoperative Complications / chemically induced
  • Postoperative Complications / etiology*
  • Tissue Adhesions / chemically induced
  • Uveitis, Anterior / complications

Substances

  • Pilocarpine