Safety and efficacy of phacoemulsification and intraocular lens implantation through a small pupil using flexible iris retractors
Journal Title: Medpulse International Journal of Ophthalmology - Year 2017, Vol 4, Issue 2
Abstract
Background: Cataract is a very common cause of blindness globally. Phacoemulsification and foldable intraocular lens (IOL) implantation is the choice of surgery for cataracts. Some patients who need cataract extraction have eyes with small pupils due to various reasons that makes the procedure difficult and leads to more complications. Flexible iris retractors can be used to retract the pupil during phacoemulsification. We compared the out¬comes of phacoemulsification through a small pupil using flexible iris retractor with those of phacoemulsification done through a well dilated pupil. Aim of the study: The aim of this study was to compare results of phacoemulsification through a small pupil using iris retractor versus through a well dilated pupil. Materials and Methods: This was a prospective study and comprised of forty patients (group A) with a maximally dilated pupil size of ≤ 4.00 mm and forty patients (group B) with dilated pupil size of ≥7.00 mm. Patients were aged between 40 years to 70 years. In group A patients, only viscodilation and flexible iris retractor was used to increase the pupil size. Phacoemulsification was performed by one single experienced surgeon. Technique used was direct chop or stop and chop. In group A patients vacuum and aspiration flow rate was little lowered during phacoemulsification. Patients were examined on day 1 and then at 1st week, 1st and 3rd month. Results: In group A patients, the mean pupil size measured under an operating microscope was 3.2mm to3.8 mm preoperatively and 5 to 5.5 mm after mechanical stretching by iris retractors. Intraoperatively no major complication was found in both the groups. In group A patients in first day postoperative period, mild corneal edema seen in two cases and mild iritis was seen in 11 cases. In group B patients there were no postoperative complications. One month postoperatively all cases had clear cornea, round pupil and anterior chamber was quiet. Conclusion: Phacoemulsification through a small pupil using flexible iris retractor is safe and clinical outcomes are at par with phacoemulsification through well dilated pupil.
Authors and Affiliations
Mamata Choudhury, Y Jayapal Reddy
Keywords
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