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November 1940

Iridosclerectomy with Anterior Cyclodialysis for Glaucoma.

Arch Ophthalmol. 1940;24(5):1065. doi:10.1001/archopht.1940.00870050217026

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The author's technic is a combination of sclerectomy, anterior cyclodialysis and peripheral iridectomy. After dissecting a conjunctival flap down to the limbus above, he makes two parallel horizontal incisions partly through the sclera, 1 mm. apart and 2 mm. from the limbus and approximately 3 mm. long. One of the scleral incisions is carried deeper until aqueous appears at one point. The sclera here is then grasped with fixation forceps, and the 1 by 3 mm. piece of sclera is excised with scissors. A spatula, bent almost at right angles, is inserted posteriorly into the filtration angle, through the scleral spur and into the suprachoroidal space and is rotated over a distance of 90 degrees. If peripheral synechiae are present, the spatula is inserted anteriorly and the synechiae freed. A peripheral basal iridectomy is then done.

The operation is indicated in all types of glaucoma except acute glaucoma and secondary

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