Pearls for Phacoemulsification in Small Pupils

Eyes with small pupils present a challenge to cataract surgeons. A pupil that fails to dilate can obscure visualization during all stages of phacoemulsification, making surgery more difficult and increasing the incidence of complications such as nucleus drop, vitreous prolapse, and iris tear. Fortunately, the availability of several intraoperative techniques and pupil-expanding devices enables phacoemulsification to be performed even in these difficult eyes. Strategies for enlargement primarily depend on th