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Management of Small Pupil During Cataract Surgery

 

Dr Sudhir Singh
Sr. Consultant  & HOD
JW  Global  Hospital Research Centre
Mount Abu  India  307501
 

Case 1 : Manual Small Incision Cataract Surgery Through Post Uveitis 1mm Small Bound Down Pupil : No Hooks No Rings

In this case pupil was not getting dilated due to massive iridocapsular adhesions.
Iridocapsular adhesions between posterior surface of the iris and anterior surface of the anterior capsule try to broken with help of the iris spatula. But could not be succeed due to massive iridocapsular adhesions iris hooks and pupil expenders would not be useful.
So we decided to do multiple small sphincterotomies in the lower half of the pupilary sphincter with the help of vannas scissors. The Cane opener capsulotomy is done with 26 gauze needle capsulotome as capsulorhexis is not possible. The nucleus is rotated within the capsule using a Sinskey’s hook. The nucleus was prolapsed into anterior chamber using a Sinskey’s hook.Then nucleus is taken out with the help of a lens loop.Cortical matter cleaned up. Anterior chamber formed by viscoelastics. IOL implanted. AC washed up. Conjunctival flap reposited. Sub conjunctival gentamycin and dexamethasone injection given.

 

 

 
Case 2:Phacoemulsification Through Post Uveitis 1mm Small Bound Down Pupil : No Hooks No Rings

 

 
Case 3:Phaco In White Hard Cataract In Non Dilated Pupil

 

 
 
Case 4: Intratunnel Phacofracture SICS In Floppy Iris and Non Dilating Pupil (With Commentary)

 

 
Case 5: MSICS In Pseudoexfoliation And Non getting Dilated Pupil (With Commentary)

 

 
Case 6:Manual SICS in Hyper Mature Cataract and Non Dilating Pupil

 

 
Case 6 : Temporal SICS in Post Trabeculectomy Non Getting Dilated Pupil

 

 
Intratunnel Phacofracture Manual Small Incision Cataract Surgery (MSICS) Video

 
Manual Small Incision Cataract Surgery (MSICS or Manual SICS) Video

 

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