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Phacoemulsification in eyes with a small pupil.

A Vasavada¹, R Singh

¹Iladevi Cataract & IOL Research Centre, Raghudeep Eye Clinic, Ahmedabad, India.

Journal of Cataract and Refractive Surgery

|September 29, 2000

Summary

Phacoemulsification in small pupils can be performed successfully with minimal iris manipulation, restoring the natural pupil size post-surgery. This technique avoids extensive pupil stretching during cataract surgery.

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Confirmation of the presence of lens epithelial cells in the anterior chamber after phacoemulsification.

Eye (London, England)·2008

Area of Science:

Ophthalmology
Surgical Techniques

Background:

Cataract surgery often requires adequate pupil dilation for safe and effective phacoemulsification.
Small or rigid pupils present unique challenges during intraocular lens (IOL) implantation.

Purpose of the Study:

To assess the feasibility and outcomes of phacoemulsification in eyes with small pupils (≤4.0 mm) using minimal iris manipulation.
To evaluate intraoperative difficulties and long-term results of this modified surgical approach.

Main Methods:

A prospective study of 30 eyes with pupil size ≤4.0 mm.
Phacoemulsification technique involved deep chamber creation, low aspiration flow, and in situ chopping.
Minimal iris manipulation, primarily synechiolysis or occasional chopper use, was employed.

Main Results:

Successful phacoemulsification was achieved in all cases with minimal or no pupil-widening maneuvers.
Postoperative pupil configuration was restored to preoperative size.
Complications included iris bruising (10 eyes), retained cortex (4 eyes), and early postoperative elevated intraocular pressure (2 eyes).

Conclusions:

Phacoemulsification through small pupils is feasible with minimal iris manipulation.
The technique effectively restores preoperative pupil configuration, offering a viable option for challenging cataract cases.

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