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Outcomes of sphincterotomy for small pupil phacoemulsification

Poster Details

First Author: J.Goh UK

Co Author(s):    R. Harrison   S. Tavassoli   D. Tole              

Abstract Details


Sphincterotomy, an alternative to iris hooks or pupil stretching, is a technique that can aid in small pupil phacoemulsification. The safety of this procedure, however, is currently unknown. This study evaluates the post-operative outcomes of phacoemulsification surgery with adjunctive pupillary sphincterotomy.


Bristol Eye Hospital, United Kingdom


A retrospective review of case notes of patients that had undergone simultaneous sphincterotomy, phacoemulsification and intraocular lens (IOL) implantation by a single surgeon between March 2012 and Feb 2017. Main outcome measures were post-operative intraocular pressure (IOP) rise (>21mmHg), uveitis and cystoid macular oedema (CMO).


125 eyes of 120 patients were included in this study. The mean age was 81 years (range: 26-100). All had uncomplicated surgery. 7 (5.6%) eyes developed a transient IOP rise at a mean follow-up of 14 days, of which 2 eyes had glaucoma and 3 were on an alpha-blocker. 3 (2.4%) eyes had persistent uveitis (>1 month) which resolved with topical therapy except for one eye with a history of uveitis. The 6 (4.8%) eyes that developed CMO had a history significant for uveitis (n=4), diabetic macular oedema (n=1) and epiretinal membrane (n=1). All CMO maculae resolved to their baseline.


The incidence of post-operative complications following uncomplicated phacoemulsification and IOL implantation with pupillary sphincterotomy is low. The most important predisposing factors for development of a complication are ocular co-morbidities such as uveitis, glaucoma and the presence of a macular pathology.

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