NON-DILATING PUPIL -USE OF IRIS HOOKS скачать в хорошем качестве

NON-DILATING PUPIL -USE OF IRIS HOOKS

Nondilating or poorly dilating pupils pose significant challenges during and after cataract surgeries. The challenges include- Reduced surgical space may lead to small capsulorhexis. This causes difficulty in manoeuvring the lens during surgery (reduced surgical access) and There is a higher chance of trauma to the anterior capsular rim/capsulorhexis edge with instruments. An anterior capsular tear may extend beyond the equator causing a posterior capsular rent (PCR). Less visibility of the peripheral lens and the placement of the tip of certain instruments. This. may increase the risk of complications including iris trauma (including chafing, sphincter tear, iridodialysis), hyphema, PCR Iris prolapse Intraoperative further reduction in pupillary dilation likely related to prostaglandins release or iris touch with instruments, Retained cortical matter in the peripheral capsular bag may swell up in the immediate postoperative period and may need surgery for removal Inadvertent placement of one haptic of intraocular lens (IOL) in the capsular bag and the other in the sulcus predisposes to iris chafing, inflammation after surgery, and concentration of the IOL after capsular healing Increased postoperative inflammation, corneal oedema, and cystoid macular oedema Intraoperative floppy iris syndrome (IFIS) is an important clinical entity which was described in 2005 by Chang and Campbell, This may cause poor pupillary dilation.[1] The iris loses tone and is flaccid in IFIS. IFIS is usually associated with oral Tamsulosin ( alpha-1A antagonist), a drug used for benign prostatic hypertrophy. Multiple other drugs can also cause a similar problem. IFIS is characterized by a triad[2][3] of Floppy and flaccid iris that billows in the fluid currents during the cataract surgery Chances of iris prolapse out of the main and side wounds Progressive intraoperative miosis.