Phacoemulsification with poorly dilated pupils

Tilting the viewing angle of the operating microscope during phacoemulsification provides the surgeon a better view of the cataractous lens. This technique, combined with continuous curvilinear capsulorhexis, divide and conquer nucleofractis, and lens rotation in the capsular bag, allows the surgeon to perform most of the phacoemulsification procedure near a well-visualized 6 o'clock meridian. This procedure can eliminate the need for iris surgery in cases with small pupils. Also discussed is the removal of the upper half of the cortical substance in patients with small pupils.