From Big Medical Encyclopedia

IRIDOTSIKLORETRAKTION (grech, iris, irid[os] rainbow + kyklos circle, eye + lat. retractio procrastination) — the antiglaukomatozny operation consisting in dissociation of a root (basis) of an iris and the forefront of a ciliary body with the filtering zone of an eye (a corner of an anterior chamber).

Diagrammatic representation of operation of an iridotsikloretraktion: and — the beginning of operation — also the otseparovana a conjunctiva is cut, the scleral rag is cut out (autoimplantat), its free end is raised for introduction to an anterior chamber of an eye, an anterior chamber of an eye small (intraocular pressure is increased), its corner is closed by a root of an iris; — introduction of the left bent scleral rag to an anterior chamber of an eye (the right rag is already entered); in — operation is complete, scleral rags are entered into an anterior chamber of an eye, the stitch on a conjunctiva is put, the anterior chamber became deeper (intraocular pressure decreased); — a gonioskopichesky picture of an anterior chamber of an eye after operation (in the field of scleral rags and between them the corner of the camera is open); 1 — a conjunctiva; 2 — scleral rags; 3 — a cornea; 4 — an anterior chamber of an eye; 5 — an iris; 6 — a pupil; 7 — a crystalline lens; 8 — a ciliary body; 9 — the line of a section of a sclera; 10 — an upper direct muscle of an eye.

Operation is shown to patients with the most severe forms of glaucoma with the closed corner of an anterior chamber of an eye when blockade of its corner is caused by unions (gonosinekhiya) and has organic character. The principle of operation consists in separation of a root of an iris and the forefront of a ciliary body from an inner surface of a wall of an eyeglobe is similar to a cyclodialysis (see). However the cyclodialysis at glaucoma of the closed corner is inefficient since the root of an iris is returned to the place and again grows together with structures of the filtering zone. For prevention of it at And. between the divided structures enter two autografts playing a role of struts. The transplant is found from periblasts of a sclera of the operated eye in the form of strips 2 X 4 X 0,5 mm (fig). At a right choice And. is pathogenetic the directed operation since it does not lead to the filtering hem and does not cause excessive decrease in the intraocular pressure leading sometimes to hypotonia.

A possible complication — hemorrhage in an anterior chamber (see. Hyphema ). It can be prevented by timely administration of air in an anterior chamber that increases pressure in a cavity of an eye and by that reduces bleeding, and also promotes replacement of the blood which already accumulated in an anterior chamber. In the postoperative period sometimes develops iridocyclitis (see).

Bibliography: Krasnov M. M. Microsurgery of glaucomas, M., 1974, bibliogr.

M. M. Krasnov.