In cases of corneal opacity when the iris is adherent to the opacity and a corneal transplantation will eventually be indicated, it is advisable to free the iris from the cornea before the keratoplasty is performed. If this is done the keratoplasty can be performed later without causing further trauma to the iris, thus preventing such additional complications as hemorrhages and traumatic inflammation of the iris during the postoperative recovery period.
The following maneuver may be used to treat an anterior synechia surgically if it is not too extensive: A slanting incision is made with a 1.0 mm wide Wheeler discission knife, starting 1.0 or 2.0 mm outside the limbus and entering the anterior chamber on the temporal side of the anterior synechia (Fig 1A). The knife is then withdrawn and a spatula, 15.0 mm long and 0.5 mm wide, with blunt edges (Fig 1C) is introduced into
CASTROVIEJO R. Surgical Treatment of Anterior Synechiae Before and After Keratoplasty. Arch Ophthalmol. 1964;72(2):240-245. doi:10.1001/archopht.1964.00970020240020