Cataract surgery in the small adult eye

Microphthalmos is a rare condition that is often associated with several other ocular abnormalities. Given the considerable differences between microphthalmic and anatomically normal eyes, cataract surgery is technically demanding in these patients, and special attention must be given to adequate preoperative planning of these procedures. Furthermore, the unique nature of these surgeries creates a particular subset of intraoperative and postoperative complications. However, with the advent of piggyback intraocular lens placement, the visual outcomes of cataract surgery in small adult eyes have improved considerably over the past 20 years. This review discusses the nature of the microphthalmic eye, and addresses proper pre-, intra-, and postoperative care of the microphthalmic patient.