Posterior synechiae after glaucoma operations: aggravation by shallow anterior chamber and pilocarpine.
Posterior pupillary synechiae affect a proportion of eyes subjected to iridectomy with or without drainage operation because (1) aqueous humour bypasses the pupil; (2) traumatic iridocyclitis occurs; (3) there is immobility of the iris in the iridectomy sector; (4) in eyes with angle closure glaucoma closer apposition of the iris to the anterior lens capsule increases the tendency; (5) pilocarpine aggravates (4) both in angle closure glaucoma and open angle glaucoma and produces a small immobile pupil facilitating pupillary membrane formation (occlusio pupillae). Pilocarpine should be avoided if possible as medical treatment at any time after a drainage operation. A beta blocker is the drug of choice. To eliminate posterior synechiae over a fair number of degrees of pupil (say 30 degrees) sector iridectomy can be done.
D000368:Aged; D000867:Anterior Chamber; D001082:Aqueous Humor / Q000502:physiology; D005260:Female; D005901:Glaucoma / Q000601:surgery*; D006801:Humans; D007498:Iris / Q000601:surgery; D007499:Iris Diseases / Q000209:etiology*; D053685:Laser Therapy; D007903:Lens Capsule, Crystalline; D007905:Lens Diseases / Q000209:etiology; D008297:Male; D010862:Pilocarpine / Q000009:adverse effects*; D011183:Postoperative Complications / Q000139:chemically induced / Q000209:etiology*; D000267:Tissue Adhesions / Q000139:chemically induced; D014606:Uveitis, Anterior / Q000150:complications
D010862:Pilocarpine