Ovoid Pupils in Cataract Surgery – What Happened?

What is happening in these cataract surgery patients with prior Flomax (tamsulosin) use? Why are the pupils ovoid in shape?

These patients have poorly dilating pupils, so the surgical technique employed here was performing the capsulorhexis under the iris so that it is a larger diameter than the pupil, then prolapsing the nucleus out of the capsular bag. The nucleus is being held by the iris in the pupil plane so it creates this ovoid shape.

Dr. Gomez has some very valuable advice for creating the capsulorhexis under the iris.

You can certainly learn this important technique. Click below for the video: