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Iris hooks aid cataract surgeons in complicated cases with narrow pupils
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BASSANO DEL GRAPPA, Italy — Iris hooks are a helpful and versatile tool in cases of cataract surgery with narrow pupils, according to one surgeon speaking at the Bassano Ophthalmology Meeting.
“There are cases where neither the preoperative administration of NSAIDs to reduce prostaglandin production nor the intraoperative use of mydriatics, including the new intracameral mydriatics, is sufficient to dilate the pupil to a safe size for surgery,” Alessandro Franchini, MD, said.
Persistent refractory pupillary constriction is often associated with pseudoexfoliation syndrome (PEX) or with floppy iris syndrome due to benign prostatic hyperplasia medications, quite commonly used by elderly patients.
“I like to use iris retractors in these cases. With floppy iris, they not only open up the pupil, but also prevent iris fluctuations, a well-known risk factor for complications,” Franchini said. “In case of PEX, where the zonule is unstable and there is a high risk of crystalline lens subluxation, I move the hooks intraoperatively from the iris to the anterior capsule. This allows me to maintain the capsular bag steady and stable during surgery and to remove the cataract and all the cortical material safely.” – by Michela Cimberle
Reference:
Franchini A. Cataract surgery complications: Narrow pupil. Presented at: Bassano Ophthalmology Meeting; April 9, 2016; Bassano del Grappa, Italy.
Disclosure: Franchini reports no relevant financial disclosures.