Managing Small Pupils Without Iris Hooks Or Any Othet Accessories With Simple Modification Of Phacoemulsification Steps

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

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

An interventional study done on 50 patients patients with small pupils.45 were of pseudoexfoliation syndrome and 5 were idiopathically small pupils with history of diabetes mellitus.Main step of phacoemulsification procedure is making continuous curvilinear capsulorrhexis with imaginary angle under the iris after injecting viscoelstic,knowing with the movement of your hands.The main step is to bring the nucleus after hydrodissection into the pupil and stretching the pupil with nucelus body.The part of nucleus above iris will be emulsified with phaco power first and then moving and dialling it with dialler and eat the portion above pupil accordingly.This method keeps the pupil stretched and doesnt require iris hooks or any other tool.

All 50 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 and supporting it.

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