Nanophthalmic eyes are very small with a short axial length of less than 20 mm. This makes the cataract surgery far more challenging due to the limited working space. The anterior chamber is typically shallow and the cataractous crystalline lens seems very large in relation to the anterior segment dimensions. In this case, the pupil is also poorly dilating and the patient suffers from iris prolapse during the procedure. While this case would have been far easier if the nucleus was relatively soft, this patient opted to wait until the cataract became quite dense.
click below to learn how to perform cataract surgery in this tiny eye:
The video above is in real-time (11 minutes). If you are pressed for time, the video below is at 2x speed and has a different commentary: