HYDRODISSECTION THROUGH PARACENTESIS IN IFIS CASES

To present a lesser-known, modified hydrodissection (HD) technique performed through the paracentesis, designed for cases of intraoperative floppy iris syndrome (IFIS) where standard hydrodissection via the main clear corneal incision (CCI) leads to repeated iris prolapse.

All procedures were performed by a single experienced refractive cataract surgeon at a surgical center using modern phacoemulsification systems under standard sterile operating conditions.

In cases of IFIS where iris prolapse occurred repeatedly through the main CCI, the author employed a modified HD technique using a Chang cannula inserted through the side port (paracentesis), while keeping the main CCI closed. A slow and gentle hydrodissection was carried out using balanced salt solution (BSS).

This technique proved effective when the main CCI was kept sealed and the hydrodissection was performed slowly and gently. The fluid wave was clearly visible, and the nucleus became freely mobile by the end of the maneuver, without any iris prolapse.

Modified hydrodissection through the paracentesis may offer a safer and more controlled approach in IFIS cases—especially in eyes with a shallow anterior chamber—by reducing the risk of iris prolapse associated with traditional hydrodissection through the main incision.