Methods for Achieving Adequate Pupil Size in Cataract Surgery

Andrzej Grzybowski; Piotr Kanclerz


Curr Opin Ophthalmol. 2020;31(1):33-42. 

In This Article


Cataract surgery in patients with a small pupil remains a challenge, and it increases the risk of intraoperative complications. There is a wide range of options to manage the small pupil, including pharmacological treatment, mechanical stretching or dilation with iris hooks or pupil expanders. The current article presents the methods for pupil dilation and the risk factors for a small pupil in a cataract patient. We recommend a stepwise approach in applying methods for intraoperative pupil dilation, from pharmacological mydriasis to pupil expanders. Every cataract surgeon needs be ready to cope with a small pupil, both manifesting preoperatively and intraoperatively.