Synechiolysis

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What is ocular synechiae? An ocular synechia is an eye condition characterized by the adhesion of the iris to either the cornea or lens. Adhesion to the cornea is known as anterior synechiae, while adhesion to the lens is known as posterior synechiae. These adhesions can lead to pupil dilation, aqueous blockage, and more. Anterior […] Read More

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Synechiolysis

What is ocular synechiae? An ocular synechia is an eye condition characterized by the adhesion of the iris to either the cornea or lens. Adhesion to the cornea is known as anterior synechiae, while adhesion to the lens is known as posterior synechiae. These adhesions can lead to pupil dilation, aqueous blockage, and more. Anterior synechiae occur at the angle of the eye where the peripheral iris obstructs the aqueous humour drainage, and in turn, this raises the intraocular pressure, and by so doing leads to angle-closure glaucoma (closed-angle glaucoma).  Posterior synechiae occur at the pupil margin where the iris adheres to the anterior lens capsule. This adhesion, in turn, causes a blockage of the flow of aqueous humour from the posterior chamber to the anterior chamber, thereby, raising the intraocular pressure. This leads to glaucoma, but with a different mechanism from that of the anterior synechiae. This also prevents dilation and makes cataract surgery more challenging. In general, an ocular Synechiae can be caused by 
  • Ocular trauma,
  • Iridocyclitis, or 
  • Iritis (inflammation of the eyes). 
It may sometimes be visible on careful examination but usually it is more easily seen through an ophthalmoscope or slit-lamp. What is an ocular synechiolysis procedure like?
  • A blunt instrument such as a 27-gauge cannula or a spatula is carefully inserted through the gap between the iris and the lens. 
  • The instrument is then swept sideways to gently break these adhesions and free the iris from the anterior lens capsule. This process is repeated in multiple times and directions until the iris is completely free.
  • After the removal of the adhesions, the pupil still remains meiotic.
  • Two chopping instruments are then used to hook the pupil margin, and stretch the pupil by pulling it towards the limbus. This gentle slow stretch helps in breaking the fibrotic membranes.
  • More viscoelastic is then injected to perform viscomydriasis by pushing the pupil margin close to the angle of the eye. 
  • A capsulorhexis forceps is then used to peel off the fibrotic membranes from the pupil margin, in a circumferential direction. 
  • This is performed slowly and gently to prevent damage to the iris. 
  • Cataract surgery can then be carried out.
How is a uterine synechiolysis procedure carried out?
  • A hysteroscope is inserted, through the vagina, into the uterus.
  • The cavity of the uterus is then inflated with liquid, and the uterus visualized on a projected screen. 
  • The adhesive bonds that have been formed by the scar tissues and adhesions are then cut out for extraction using sharp scissors.
  • All synechiolysis procedures are carried out under vision, to avoid damage to healthy endometrium in the process.
 

FAQ

What is the synechiolysis definition?

Synechiolysis is a surgical technique carried out for the correction of synechiae.

What Is Uterine Synechiolysis?

Uterine synechiolysis is the division of the scar tissues or adhesions that form inside the cavity of the uterus. This synechiolysis procedure is, however, performed hysteroscopically.

What is uterine synechiae?

The coming together of scar tissue and adhesions for a formation inside the cavity of the uterus.