When managing a small pupil during cataract procedures, surgeons should take their time and use all the tools in their armamentarium for successful outcomes, said Kendall E. Donaldson, MD, MS.
Dr. Donaldson shared the example of a normal-sized versus small pupil and what would happen if the size of each one decreased by 2.5 mm. For a 6-mm pupil, that change decreases the operative field by 66% versus 50% for an 8.3-mm pupil.
“Not being able to see can complicate cataract surgery,” said Dr. Donaldson, associate professor of ophthalmology, Bascom Palmer Eye Institute, University of Miami Miller School of Medicine, Miami.
Small pupils often are not the only problem a surgeon will manage in these complicated cases.
“There’s often intraoperative floppy iris syndrome, pseudoexfoliation, diabetes, uveitis, longer surgery, prior surgery or trauma, and use of the femtosecond laser,” Dr. Donaldson said.
Always examine the other eye as well for potential small pupil issues, she added.
Dr. Donaldson addressed the research that reported that femtosecond laser (FLACS) use could lead to a smaller pupil.