This patient sustained trauma which caused a cataract but it also resulted in permanent mydriasis with a pupil size of 8mm in diameter. To address this, the cataract surgery was performed and then a prosthetic iris implant was placed into the capsular bag. This device simulates a 4 mm pupil and will dramatically improve the glare symptoms since the amount of light entering the eye will be reduced by about 75%. (8mm diameter pupil area is 16π square mm whereas 4 mm diameter pupil area is 4π square mm). This device is quite large and it is a challenge to implant it in the capsular bag. There are some great pearls and hints in this video such as the best capsulorhexis size, whether trypan blue dye should be used, and the two handed technique to “tire-iron” the implant into position.
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