Pupil stretching works. And it works well without additional instrumentation or devices. In this example the pupil went from 3.9 mm I diameter to 5.1 mm in diameter and that is a 30% increase of pupil diameter. When we look at the increase in pupil area it is more dramatic, from about 12 square mm to about 20 square mm. That is an increase in area of about 67%.
A well-dilated pupil facilitates cataract surgery and if the patient has a small pupil there are multiple options for safely completing the case. We have reviewed the techniques of pupil stretching, using iris hooks, and even prolapsing the nucleus into the iris plane. We want to avoid struggling during cataract surgery because of a smaller pupil.
Just a mild stretch of the pupil in a single direction is all it takes. The rest of the case is now much easier and it can be completed efficiently and safely. This complete cataract case just takes a few minutes. And if you don’t have an extra chopper on your tray, remember that you can also do the pupil stretch with just one chopper and the capsulorhexis forceps like this:
click below to learn how a single pupil stretch can facilitate cataract surgery: