Delayed iris prolapse with unsutured 5.1 mm clear corneal incisions

I describe two cases of iris prolapse after sutureless 5.1 mm clear corneal incision cataract surgery with implantation of a 5 mm poly(methyl methacrylate) lens. Both patients reported having exerted localized digital pressure on the globe peripheral to the temporally located incision. Following resection of the prolapse, the pupil was reconstructed in situ using a translimbal transfixation technique. The prolapse and other observed complications (e.g., transient pupillary capture, delayed endophthalmitis) indicate that 5.1 mm clear corneal incisions do not provide adequate stability if localized pressure is exerted peripheral to the wound. Thus, securing the incisions with a radial 10-0 nylon suture is strongly advocated to provide sufficient wound stability against deformation.