Session Title: Vitreoretinal Surgery II
Session Date/Time: Friday 12/09/2014 | 14:30-16:00
Paper Time: 15:18
Venue: Boulevard C
First Author: : T.Papathomas UK
Co Author(s): : S. Murjaneh
Five patients in our clinic were noted with dilated pupil after vitrectomy and argon laser treatment. Our purpose is to highlight these cases and discuss the incidence and aetiology.
A large ophthalmology department in UK.
Five patients underwent uneventful pars plana vitrectomy and argon laser treatment and presented with dilated pupil. Indication for vitrectomy was rhegmatogenous retinal detachment for three of them and dense vitreous haemorrhage due to proliferative diabetic retinopathy for the other two. Two of these patients had the operation performed locally and the other three, had their operations in different units. These patients were followed-up in our clinic and a dilated pupil was reported by patients and observed clinically. Four of these patients were treated successfully with Pilocarpine 2% and the remaining one was not treated.
A tonic pupil is a dilated pupil unresponsive to light stimuli with decreased response to accommodation and denervation super-sensitivity to dilute cholinergic agents. Intense laser burns may cause damage to the short ciliary nerves traversing the choroid and is a possible cause of this surgical outcome. However, as this complication is rarely reported, it may be that other factors are participating in its presentation.
Only a few cases of dilated pupil after vitrectomy and argon laser treatment are described in literature. We feel that the incidence of dilated pupil post vitrectomy is under reported and that prospective national data is required for better information about the incidence and potential associated factors.