Iris retractors combined with a full-field non-contact lens applied in vitreous surgeries of patients with small pupils

Abstract

Objective To explore the feasibility and advantages of iris retractors combined with a full-field non-contact lens used during vitreous surgeries of patients with small pupils.Methods Twenty-four patients were included in this prospective cohort study during February to June 2010 in Lihuili Hospital of Ningbo.The experimental group consisted of 12 patients (12 eyes),all of who had small pupils but needed vitrectomy.All vitreous surgeries in the experimental group were carried out with the help of iris retractors as well as full-field non-contact lenses.For those with cloudy lenses,which affect the operation,phacoemulsifications were also performed.The control group consisted of 12 patients (12 eyes) with normal pupils who needed vitreous surgeries during the same period of time.Closed pars plana vitrectomies with contact lenses were used on them.All patients were followed up for 6-12 months,and then the differences in visual acuity,the corneal epithelium,and retinal reattachment between the two groups were analyzed.Statistical analysis included the Mann-Whitney rank sum test,independent samples t test and Fish's exact test.Results There was no significant difference between the experimental and control groups for postoperative visual acuity; 1 eye in the experimental group and 2 eyes in the control group had recurrent retinal detachment,but there was no significant difference in retinal reattachment between the two groups.Corneal endothelial loss in the experimental and control groups was (15.7±6.9)％ and (16.1±6.4)％,respectively,with no significant differences between the two groups.No complications such as iridothexis or iris atrophy occurred.Conclusion The iris retractor is a useful implement in the course of phacoemulsification and vitrectomy with a small pupil,and it fully exposed the surgical field.A full-field non-contact lens is appropriate for use with an iris retractor rather than a corneal contact lens.Futhermore,it provides a clear and complete view during surgery.An iris retractor combines with a non-contact full-field lens is simple and safe for use in vitreous surgeries of patients with small pupils. Key words: Vitrectomy; Miosis; Iris retractor; Full-field non-contact lens