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Handling the inadequate pupil

Poster Details

First Author: S.Fazili INDIA

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Abstract Details


A pupil less than 4mm makes operative strategy easy , pupil expanders are unavoidalble. It is the 4 - 5 mm pupil which can be a surgical challenge . Operating through this pupil requires greater levels of skill and danger of iris and rhexis accidents , inadequate cortical wash and higher incidence of capsular contraction


Fazili Eye Care Center , Srinagar , Jammu & Kashmir , India


Step one : Intracameral adrenaline and viscoe dilataion Step two : posterior synectomy , if posterior synechia are present Step three : Bimanual stretching Step four : Pupil expanders - iris hooks , Malyugin ring If such a pupil is associated with zonular weakness e.g., in pseudoexfoliation , it is always prudent to use pupil expanders in anticipation of further surgical challenge . Iris touch or manipulation in cases with floppy iris may cause intraoperative miosis , which has to be tackled with iris hooks , greater care to be taken if the rhexis has already been made . Iridoschiesis presents a similar problem. Excerpts of videos can be seen on you tube ' Handling the inadequate pupil - ' Sajjad Fazili


The inadequate pupil , by adequate surgical manaevers , does not exist.


Following a protocol and dynamic decision making , the small pupil no longer should be a challenging and unpredictable surgery . FINANCIAL INTEREST: NONE

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