The toric IOL is a great option to address astigmatism at the time of cataract surgery. For the toric IOL to have the best effect, it must be precisely oriented at the correct meridian. The challenge with a smaller pupil is that the toric marks on the IOL optic are at the 5 to 6 mm zone which makes them hidden behind the iris. The technique that we use is lifting the iris with the chopper while keeping the anterior chamber inflated with the balanced salt solution infusion.
click below to learn how to use toric IOLs in small pupil cases: