Iris retractor in phacoemulsification under small pupil

Objective To compare the surgical complications and outcome of visual function between using iris retractor and radial corotomy in phacoemulsification under small pupil.Methods 58 eyes of 52 cataract patients with small pupil underwent phacoemulsification and intraocular lens implantation.They were divided into two groups:42 eyes by using iris retractor for dilating the pupil,and 16 eyes by radial corotomy as control.Results In the group of using iris retractor,the operation time was (29 ± 6) min,and phacoemulsification time was (58 ± 12)s.The complications were intraoperative iris bleeding in 10 eyes(23.81％),injury of the iris by phacoemulsification tip in 2 eyes(4.67％),and posterior capsule rupture during the operation in 1 eye(6.25％).Visual acuity was better than 0.3 in 33 eyes on the first day,and was improved in 38 eyes compared with that before surgery at 3 months postoperatively.The time of getting best final visual acuity was 13 days.On the first day after surgery,there were 38 eyes with corneal edema,28 eyes with anterior chamber reaction,and 28 eyes with pupil deformation.And there were 8 eyes with pupil deformation,20 eyes with sluggish pupil light reflex and no light reflex in 6 eye one week after surgery.In the control group,the operation time was (20 ± 4)min,and phacoemulsification time was (105 ± 18) s.16 eyes (100％) had intraoperative iris bleeding,10 eyes (62.50％) had injury of the iris by phacoemulsification tip,and 1 eye (6.25％) had posterior capsule rupture during the operation.Visual acuity was better than 0.3 in 8 eyes on the first day after surgery,and the visual acuity of 1 4 eyes at 3 months after surgery was improved compared with that before surgery.The time of getting best final visual acuity was 29 days.On the first day after surgery,there were 15 eyes with corneal edema,16 eyes with anterior chamber reaction,16 eyes with pupil deformation.And there were 15 eyes with pupil deformation,12 eyes with pupil light reflex and no light reflex in 4 eye one week after surgery.There were statistically significant differences in operation time,phacoemulsification time,postoperative vision and complications between two groups.Conclusion Using iris retractor in phacoemulsification on condition of small pupil may minimize the injury of iris,dilate pupil well,reduce the inflammation,and increase safety of the operation. Key words: Retractor, iris;  Corotomy, radial;  Miosis;  Surgery, cataract;  Study, case control