Pupilloplasty in aphakic and pseudophakic pupillary block glaucoma.

Pupilloplasty has given positive results in 40 out of 45 cases of aphakic and pseudoaphakic secondary block glaucoma after one or two laser sessions. Since we first applied this method we have arrived at the following conclusions: Pupilloplasty must be repeated whenever the reformation of the anterior chamber achieved with the first laser session does not persist. [In our instances the anterior chamber was successfully reformed at the first session and maintained its depth in 30 of the 40 cases. In the remaining 10 cases a second pupilloplasty proved necessary 2 to 5 days after the first session (rate of success: 88 per cent)]. In the cases in which the anterior chamber was reformed intraocular pressure showed certain fluctuations before stabilising at the desired levels. The intensity of the laser beam applied in cases of pupillary block with pseudophakic anterior chamber should be relatively lower than the intensity used in aphakic cases. In order to prevent corneal burns in cases with shallow or completely flat anterior chambers the first two laser applications should be of a lower beam intensity than usual.