Managing Small Pupillas Without Iris Hooks Or Any Other Accessories With Simple Modification Of Phacoemulsification Steps

Main goal is to do smooth phacoemulsification in small pupils due to different causes without the use of any iris hooks or accessories

Modification of regular phacoemulsification procedure and making it smooth for small pupils as small pupils are everyday problem due to many causes.

A prospecutive interventional study design done on 70 patients with small pupils.55 were of pseudoexfoliation syndrome and 15 were idiopathically small pupil.10 patients among idiopathic were diabetic as well.Main method in the step of phacoemulsification is making continuous curvilinear capsulorrhexis with imaginary angle under the iris knowing with the movement of your hands.After that main step is to bring the nucleus after hydrodissection into the pupil and stretching the pupil with nucleus.The part of nucleus above iris with be emulsified with phacoprobe  first and then moving and dialling it with probe and round eaten accordingly.This method keeps the pupil stretched and doesnt require iris hooks or any other tool.

All 70 patients underwent uncomplicated phacoemulsification with no posterior capsular rupture.3 patients had weak zonules but the intraocular lens was placed in the capsule making it stretched.

This method can be easily adapted in any setting especially in a developing country like Pakistan where accessories for small pupil may not available and even if it is available ,i personally dont like to make seperate ports for hooks etc.So with time modified normal phacoemulsification steps to go smooth for small pupils and it made my life easier.