Medical and surgical management of the small pupil during cataract surgery.
Saba Al-Hashimi, Kendall Donaldson, Richard Davidson, Deepinder Dhaliwal, Mitchell Jackson, Jeremy Z Kieval, Larry Patterson, Karl Stonecipher, David R Hamilton, ASCRS Refractive Cataract Surgery Subcommittee
Author Information
Saba Al-Hashimi: From the Stein Eye Institute and Department of Ophthalmology (Al-Hashimi, Hamilton), David Geffen School of Medicine, University of California Los Angeles, Los Angeles, California, the Bascom Palmer Eye Institute (Donaldson), Miller School of Medicine, Plantation, Florida, the University of Colorado Eye Center (Davidson), University of Colorado School of Medicine, Denver, Colorado, the UPMC Eye Center (Dhaliwal), University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania, Jacksoneye (Jackson), Lake Villa, Illinois, Lexington Eye Associates (Kieval), Lexington, Massachusetts, Eye Centers of Tennessee (Patterson), Crossville, Tennessee, and the Department of Ophthalmology (Stonecipher), University of North Carolina, Chapel Hill, North Carolina, USA.
Kendall Donaldson: From the Stein Eye Institute and Department of Ophthalmology (Al-Hashimi, Hamilton), David Geffen School of Medicine, University of California Los Angeles, Los Angeles, California, the Bascom Palmer Eye Institute (Donaldson), Miller School of Medicine, Plantation, Florida, the University of Colorado Eye Center (Davidson), University of Colorado School of Medicine, Denver, Colorado, the UPMC Eye Center (Dhaliwal), University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania, Jacksoneye (Jackson), Lake Villa, Illinois, Lexington Eye Associates (Kieval), Lexington, Massachusetts, Eye Centers of Tennessee (Patterson), Crossville, Tennessee, and the Department of Ophthalmology (Stonecipher), University of North Carolina, Chapel Hill, North Carolina, USA. Electronic address: kdonaldson@med.miami.edu.
Richard Davidson: From the Stein Eye Institute and Department of Ophthalmology (Al-Hashimi, Hamilton), David Geffen School of Medicine, University of California Los Angeles, Los Angeles, California, the Bascom Palmer Eye Institute (Donaldson), Miller School of Medicine, Plantation, Florida, the University of Colorado Eye Center (Davidson), University of Colorado School of Medicine, Denver, Colorado, the UPMC Eye Center (Dhaliwal), University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania, Jacksoneye (Jackson), Lake Villa, Illinois, Lexington Eye Associates (Kieval), Lexington, Massachusetts, Eye Centers of Tennessee (Patterson), Crossville, Tennessee, and the Department of Ophthalmology (Stonecipher), University of North Carolina, Chapel Hill, North Carolina, USA.
Deepinder Dhaliwal: From the Stein Eye Institute and Department of Ophthalmology (Al-Hashimi, Hamilton), David Geffen School of Medicine, University of California Los Angeles, Los Angeles, California, the Bascom Palmer Eye Institute (Donaldson), Miller School of Medicine, Plantation, Florida, the University of Colorado Eye Center (Davidson), University of Colorado School of Medicine, Denver, Colorado, the UPMC Eye Center (Dhaliwal), University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania, Jacksoneye (Jackson), Lake Villa, Illinois, Lexington Eye Associates (Kieval), Lexington, Massachusetts, Eye Centers of Tennessee (Patterson), Crossville, Tennessee, and the Department of Ophthalmology (Stonecipher), University of North Carolina, Chapel Hill, North Carolina, USA.
Mitchell Jackson: From the Stein Eye Institute and Department of Ophthalmology (Al-Hashimi, Hamilton), David Geffen School of Medicine, University of California Los Angeles, Los Angeles, California, the Bascom Palmer Eye Institute (Donaldson), Miller School of Medicine, Plantation, Florida, the University of Colorado Eye Center (Davidson), University of Colorado School of Medicine, Denver, Colorado, the UPMC Eye Center (Dhaliwal), University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania, Jacksoneye (Jackson), Lake Villa, Illinois, Lexington Eye Associates (Kieval), Lexington, Massachusetts, Eye Centers of Tennessee (Patterson), Crossville, Tennessee, and the Department of Ophthalmology (Stonecipher), University of North Carolina, Chapel Hill, North Carolina, USA.
Jeremy Z Kieval: From the Stein Eye Institute and Department of Ophthalmology (Al-Hashimi, Hamilton), David Geffen School of Medicine, University of California Los Angeles, Los Angeles, California, the Bascom Palmer Eye Institute (Donaldson), Miller School of Medicine, Plantation, Florida, the University of Colorado Eye Center (Davidson), University of Colorado School of Medicine, Denver, Colorado, the UPMC Eye Center (Dhaliwal), University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania, Jacksoneye (Jackson), Lake Villa, Illinois, Lexington Eye Associates (Kieval), Lexington, Massachusetts, Eye Centers of Tennessee (Patterson), Crossville, Tennessee, and the Department of Ophthalmology (Stonecipher), University of North Carolina, Chapel Hill, North Carolina, USA.
Larry Patterson: From the Stein Eye Institute and Department of Ophthalmology (Al-Hashimi, Hamilton), David Geffen School of Medicine, University of California Los Angeles, Los Angeles, California, the Bascom Palmer Eye Institute (Donaldson), Miller School of Medicine, Plantation, Florida, the University of Colorado Eye Center (Davidson), University of Colorado School of Medicine, Denver, Colorado, the UPMC Eye Center (Dhaliwal), University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania, Jacksoneye (Jackson), Lake Villa, Illinois, Lexington Eye Associates (Kieval), Lexington, Massachusetts, Eye Centers of Tennessee (Patterson), Crossville, Tennessee, and the Department of Ophthalmology (Stonecipher), University of North Carolina, Chapel Hill, North Carolina, USA.
Karl Stonecipher: From the Stein Eye Institute and Department of Ophthalmology (Al-Hashimi, Hamilton), David Geffen School of Medicine, University of California Los Angeles, Los Angeles, California, the Bascom Palmer Eye Institute (Donaldson), Miller School of Medicine, Plantation, Florida, the University of Colorado Eye Center (Davidson), University of Colorado School of Medicine, Denver, Colorado, the UPMC Eye Center (Dhaliwal), University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania, Jacksoneye (Jackson), Lake Villa, Illinois, Lexington Eye Associates (Kieval), Lexington, Massachusetts, Eye Centers of Tennessee (Patterson), Crossville, Tennessee, and the Department of Ophthalmology (Stonecipher), University of North Carolina, Chapel Hill, North Carolina, USA.
David R Hamilton: From the Stein Eye Institute and Department of Ophthalmology (Al-Hashimi, Hamilton), David Geffen School of Medicine, University of California Los Angeles, Los Angeles, California, the Bascom Palmer Eye Institute (Donaldson), Miller School of Medicine, Plantation, Florida, the University of Colorado Eye Center (Davidson), University of Colorado School of Medicine, Denver, Colorado, the UPMC Eye Center (Dhaliwal), University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania, Jacksoneye (Jackson), Lake Villa, Illinois, Lexington Eye Associates (Kieval), Lexington, Massachusetts, Eye Centers of Tennessee (Patterson), Crossville, Tennessee, and the Department of Ophthalmology (Stonecipher), University of North Carolina, Chapel Hill, North Carolina, USA.
: From the Stein Eye Institute and Department of Ophthalmology (Al-Hashimi, Hamilton), David Geffen School of Medicine, University of California Los Angeles, Los Angeles, California, the Bascom Palmer Eye Institute (Donaldson), Miller School of Medicine, Plantation, Florida, the University of Colorado Eye Center (Davidson), University of Colorado School of Medicine, Denver, Colorado, the UPMC Eye Center (Dhaliwal), University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania, Jacksoneye (Jackson), Lake Villa, Illinois, Lexington Eye Associates (Kieval), Lexington, Massachusetts, Eye Centers of Tennessee (Patterson), Crossville, Tennessee, and the Department of Ophthalmology (Stonecipher), University of North Carolina, Chapel Hill, North Carolina, USA.
As cataract surgery continues to evolve, the intraoperative small pupil continues to pose challenges to even the most experienced cataract surgeon. Several steps can be taken preoperatively to decrease the chance of intraoperative miosis. Even so, the problem of miosis during cataract surgery remains a relatively common occurrence. This paper discusses many steps, both preoperative and intraoperative, that can make surgery technically easier and safer, thus maximizing the postoperative outcomes and patient satisfaction. Complications associated with small-pupil cataract surgery, risk factors for intraoperative miosis, the preoperative and intraoperative management of the small pupil during cataract surgery, and postoperative care are reviewed.
