Abstract

P 289

Radial pupillotomy for treatment of extreme pupillary ectopia after CO2-Laser treatment

Andreas K. Cordes
Klinik für Augenheilkunde, Kliniken der Stadt Köln gGmbH, Köln

Objective
Extreme pupillary ectopia in children are rare. In cases with blocked optical axis therapeutical options are needed to prevent ambyopia. The presented case showes long-term complications of a CO2-Laser treatment for hemangioma.
Methods
A six-year-old child presented with an extreme traumatic pupillary ectopia with disturbance oft the optical axis. The patient was treated with a CO2-Laser for a lid hemangioma with an CO2-laser. In the following years the patient developed an inferior symblepharon and an extreme inferior pupilary ectopia.
Results
To free the optical axis we treated the patient with a radial pupillotomy. Additionally we performed a conjunctival adhesiolysis for treatment of the symblephara. In the postoperative phase the patient had an improved quality of life due to improved bulbar motility. In respect to treatment of amblyopia marginal improvemants could be archieved only.
Conclusions
There are several principal therapeutic options for treatment of a maximal pupillary ectopia: optical basal iridotomy, permanent pupillary mydriasis with atropin or pupilloplasty with dilatating sutures. With radial pupillotomy we present a surgical procedure for freeing of the optical axis with relative low surgical risk in phacic eyes. Furthermore this case shows the necessity of a safe protection of the bulbus during CO2-treatment for ocular hemangioma.

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