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Managing small pupils during phaco cataract surgery, part 3
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In this series of videos, Alessandro Galan, MD, shows different ways to deal with small pupils during cataract surgery.
Part 3: Small pupil — retractors
Iris retractors can be used with small but non-fibrotic pupils. In these cases, mechanical stretching does not work and may stimulate further pupil constriction. Iris retractors are placed in a diamond configuration through four small incisions. Each retractor is gently pulled to gradually obtain the aperture that allows the surgeon to gain access to the crystalline lens. A central “phaco chop” technique is used to avoid contact and damage to the iris. The wide aperture makes cortex aspiration and IOL implantation easy and safe. At the end of surgery, the iris retractors are removed and the pupil goes back to its natural round shape. However, the traction may lead to sphincter lesions in some cases.
To see the other parts of this series click here: Part 1, Part 2, Part 4.
- For more information:
- Alessandro Galan, MD, OSN Europe Edition Board Member, is head of ophthalmology at Sant’Antonio Hospital, Padua, Italy. He can be reached at can be reached at Ospedale Civile Sant’Antonio, Via Facciolati 121, Padova, Italy; email: alessandro.galan@gmail.com.
Disclosure: Galan reports no relevant financial disclosures.