Quiz: Why does this pupil look irregular?

This patient is undergoing a combined cataract surgery with a pars plana vitrectomy. Two novice surgeons are operating: a senior resident is doing the phaco and IOL insertion while the retina fellow is doing the posterior segment surgery.

Throughout the case, the iris behaved normally and the pupil was round. But after insertion of a three-piece IOL, the pupil looked quite peaked. The two surgeons decided to leave it alone, hoping that the pupil would return to a normal configuration after healing. That did not work.

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  1. Thank you for this website. Studying all of these videos as totally changed the way I do surgery resulting in improved efficiency. You are doing a great service for ophthalmology especially in developing countries were teaching resources and opportunities are hard to come by. Kind regards.

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