METHODS: Twenty eight patients(30 eyes)suffered from acute attack of glaucoma with large pupil and cataract, received cataract phacoemulsification and intraocular lens implantation combined with angle separation or trabeculectomy and single-pass four-throw pupilloplasty in apllication. Preoperative and postoperative visual acuity, pupil diameter and complications were observed, and postoperative visual quality were measured.

RESULTS: The visual acuity of 7d after operation was significantly improved without double vision and glare. The preoperative pupil diameter was 5.9+0.25mm, and the postoperative was 4.1±0.13mm(P<0.05). Postoperative visual quality was significantly improved(P<0.05). Among the intraoperative complications, there were 5 cases 5 eyes of iridodelamination avulsion after suture, 1 case 1 eye of small holes near the formed pupil and 3 cases 3 eyes of small blood seepage at the iris root, which recovered well after the corresponding treatment. The inflammation of anterior chamber were common at the early postoperative period, and inflammatory absorption after anti-inflammatory treatment. Long-term observation showed no loosening or shedding of the line knot in the pupil area.

CONCLUSION: Single-pass four-throw pupilloplasty is simple, safe and effective. It can obviously eliminate the visual impairment caused by the large pupil after acute glaucoma attack.