Slit-lamp visualization of aqueous flow through an inferior iridectomy.

Abstract

To demonstrate how an inferior iridectomy prevents a pupillary block in aphakic patients with a silicone oil tamponade. Observational case series. Photographs of two patients who had undergone vitrectomy, lensectomy, membrane peeling, silicone oil tamponade, and inferior iridectomy for a complex retinal detachment were evaluated. In the thin layer of erythrocytes covering the endothelium, we observed an arc clear of erythrocytes anterior to the inferior iridectomy. With silicone oil blocking the pupil, aqueous humor was channeled through the inferior iridectomy with sufficient force to sweep the endothelium anterior to the iridectomy clean of erythrocytes, thus visualizing the mechanism that prevents a pupillary block glaucoma.