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First Author: P.Zola ITALY
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To discuss about one of the most frequent intraoperative surgical complication, pupillar miosis
Di Stefano Velona Medical Clinic Catania, Italy
The authors show some pictures concerning a case report which presents one of the most frequent intraoperative complication and discuss the pros and cons of different approaches in the management of it .
Cataract surgery is nowadays a safe procedure. Anyway, some intraoperative complications may occur. Some are related to the patient, others to the surgical procedure. Intraoperative complications include: miosis, capsular break, iris damage, IOL decentration, vitreous push, corneal endothelium damage. In particular, the intraoperative miosis may be managed by different ways. If the miosis occur at the beginning of surgery, the best approach is pupil stratching and it is possible to manage it by the employment of iris retractors. They are effective but make the surgery longer. When the miosis occurs during surgery, some of these cases are generally predictable, pupils which dont dilate with the pharmacological therapy, IFIS, PEX, high myopia.In these cases the use of a surgical technique of mini-incision and the avoiding of a surgical procedure which may stimulate iris, is the most correct way. In other cases the miosis during the phaco-emulsification surgery is an unexpected and unpleasant event and needs to be managed in the best way.
Intraoperative miosis is a not predictable surgical complication in most of cases. Its management depends on some factors: the surgeon expertise, the variables related to surgery and the efficacy of the medical device that are available for surgeons (i.e. Mini-incision IOLs).