The Clinical Results of Small Pupil Phacoemulsification

ABSTRACT

Phacoemulsification of cataracts with small pupils would induce serious complications in some instance, but we could perform phacoemulsification and IOL implantation in the posterior chamber without any serious complications.We did not need any iris retractors or adjacent iris surgery.Thirty-one eyes of 28 patients with a pupil diameter equal to or less than 4 mm at the beginning of the procedure were reviewed.We analyzed them in the preoperative ocular problems, the size of pupil and the method of enlargement, the technique of nucleus removal, complications, and vision after six months follow-up.Preoperative pupillary diameter was less than 3 mm in 26 cases (83.9%), the most frequent preoperative ocular problem was uveitis with 19 eyes (61.36%).Removing pupillary membrane, releasing of synechiae and mechanical pupillary stretch followed by viscoelastic injection were effective in pupillary expansion.Central phaco chop technique was effective in small pupil cases.In complications, focal corneal edema in 7 eyes and mild iris damage in 6 eyes during surgery.Postoperatively, fibrinous reaction developed in 8 eyes.Postoperative corrected vision of 0.5 or better was in 15 eyes (48.4%), and 22 eyes (71%)had visual increment by 2 lines or more in the Hann's vision chart.In conclusion, phacoemulsification of cataracts with small pupils could be performed safely without serious complications, even with no iris retractor or iris surgery).