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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
Reese AB. Iridosclerectomy with Anterior Cyclodialysis for Glaucoma. Arch Ophthalmol. 1940;24(5):1065. doi:10.1001/archopht.1940.00870050217026
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