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November 1988

Intraocular Diathermy for Pupilloplasty During Vitreous Surgery

Arch Ophthalmol. 1988;106(11):1503-1504. doi:10.1001/archopht.1988.01060140671009

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To the Editor.  —A small pupil can hinder visualization during vitreous surgery. We routinely dilate the pupils of all patients preoperatively, and we use intraocular epinephrine hydrochloride during surgery to maintain dilatation in selected patients. If the pupil does not dilate pharmacologically, in the aphakic patient we use the vitrectomy instrument to perform an iridectomy. We frequently find that an iridectomy performed in this manner results in a cosmetically unacceptable scalloped or irregular pupillary border (Fig 1). In an attempt to produce an anatomically smooth pupillary border, additional cuts with the vitrectomy instrument are often required, and the surgeon may excise more of the iris than originally intended.We have used the intraocular endodiathermy probe to cauterize the cut irregular edges of the iris after iridectomy (Fig 2). The endodiathermy probe (Medical Instruments Research Associates, Waltham, Mass) is applied at a setting of 0.5 in a sweeping motion along the

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