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John Kanellopoulos MD
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John Kanellopoulos, MD, presents a cataract procedure in patient with a non-dilating pupil and floppy iris syndrome. While making the capsulorhexis, the part of the iris gets trapped in the wound. In order to achieve adequate visualization and operating space, iris hooks are placed in a hexagonal pattern.
Posted: 7/10/2013
John Kanellopoulos MD
John Kanellopoulos, MD, presents a cataract procedure in patient with a non-dilating pupil and floppy iris syndrome. While making the capsulorhexis, the part of the iris gets trapped in the wound. In order to achieve adequate visualization and operating space, iris hooks are placed in a hexagonal pattern.
Posted: 7/10/2013
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nathaniel ruttig
12 years ago
for IFIS cases, pre-op atropine, twice daily starting 3 days before surgery, and in the pre-op area using 3 drops of 10% phenylephrine given 5 minutes apart starting 30 minutes prior to surgery will greatly help dilate the pupil. Using Viscoat in an IFIS case will always lead to problems if not inserting hooks/ring, because it is not strong enough to dilate or hold a pupil. Discovisc is the way to go, one vial is enough to re-inflate and do an entire case, including re-inflating the bag prior to lens implantation.
ari weitzner
12 years ago
very surprised you stretched pupil--well known to be contraindicated in flomax pupil. since pupil small, i would have inserted malyugin before trying rhexis- too hard to do rhexis with small pupil. would have avoided iris shredding. i like malyugin better than hooks. thanks for posting. good to learn from mistakes!