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¹İzmir Atatürk Eğitim ve Araştırma Hastanesi Göz Kliniği Başasistanı, İzmir, Op. Dr.
²İzmir Atatürk Eğitim ve Araştırma Hastanesi Göz Kliniği Şefi, İzmir, Prof. Dr. Purpose: To evaluate the effect of flexible iris hook retractors (FIHR) used in phacoemulsification in patients with small pupil on the function of iris sphincter and corneal topography
Materials ve Methods: Phacoemulsification was performed in 15 patients with small pupil and 15 patients with normal dilated pupil between January 2004 and March 2005. FIHR was performed in patients with small pupil at 4 points through a symmetrical corneal incision. Pupil diameter was measured preoperatively, intraoperatively when FIHR was placed and postoperatively when FIHR was removed. Patients were evaluated with respect of complication, irregularity of the iris, visual acuity and corneal topography. Corneal topography was performed preoperatively and postoperatively and corneal astigmatism and topographic irregularity were compared between the two groups.
Results: The reasons for poor pupil dilatation were as follows: Posterior synechia in 8 patients, pseudoexfolation in 4 patients, preexisting surgery in 1 patient and use of miotics in 2 patients. FIHR was performed in all patients successfully and no complication was seen intraoperatively. Minimal sphincter irregularity was seen in 8 patients and permanent irregularity of the pupil was seen in 4 patients with FIHR, postoperatively. Visual acuity was improved in all patients and pupil was regular in 26 eyes and response to the light stimulus was normal in postoperative follow-up. There was no significant difference between the two groups with respect to corneal astigmatism and topographic irregularity (p>0.05 for all)
Conclusion: FIHR used in phacoemulsification in patients with small pupil is a safe technique and facilitates the phaco surgery with high risk when performed by experienced surgeons. On the other hand there was no significant effect on corneal topography, pupil size and shape. Keywords : Flexible iris hook retractors, small pupil, phacoemulsification, corneal topography