Intraoperative management of iris prolapse using iris hooks

Iris prolapse has become an unusual and generally benign event in routine cataract surgery using endocapsular phacoemulsification techniques. We operated on the second eye of a patient with hyperopia whose first eye surgery in our care had been uneventful. In the second eye, as soon as the phaco incision was made and hydrodissection begun through the primary incision, the iris repeatedly prolapsed through the incision. This was managed definitively by applying iris hooks, 1 at each side of the primary incision, to the pupillary border so the prolapsing iris was held peripherally in the anterior chamber and under modest tension.