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May 1977

Management of Irreversible Mydriasis After Penetrating Keratoplasty

Author Affiliations

Paisley, Renfrewshire, Scotland

Arch Ophthalmol. 1977;95(5):895. doi:10.1001/archopht.1977.04450050173025

To the Editor.—Irreversible mydriasis after penetrating keratoplasty has been reported in the literature.1-3 Pupillary abnormality after retinal detachment operation is presumed to be due to impairment of function of the short ciliary nerves. This condition can pose several problems in a young person, and I would like to report the treatment of one such case.

Report of a Case.—A 39-year-old man had a 6.1-mm penetrating keratoplasty in April 1972. Although the postoperative recovery was uneventful, his pupil remained fully dilated two months after discontinuing treatment with 1% atropine drops. Treatment with demecarium bromide (0.5%) or echothiophate iodide (Phospholine Iodide) (0.125%) could not influence the size of the pupil after seven-day instillations. The patient complained of glare and blurring of vision, although his pinhole visual acuity was 6/9. We fitted him with a shell contact lens with the iris pattern (similar to the other eye) painted onto the lens,

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