title: Efficiency of pupillary stretching in cataract surgery.
abstract: OBJECTIVE
  To assess the efficiency of pupillary stretching with iris hooks in poorly dilatable pupils during phacoemulsification.
  
  
  METHODS
  Forty eyes with maximal preoperative mydriasis less than 4.5 mm (mean 3.9 mm S.D. 1.0) received bimanual pupillary stretching according to the technique of Miller and Keener (1994).
  
  
  RESULTS
  Small pupils were mainly caused by long-term pilocarpine therapy (n = 21), posterior synechia (n = 11) or diabetic iridopathy (n = 7). With multidirectional stretching, the pupil could be enlarged to mean 6.6 mm (S.D. 0.66), lasting throughout phacoemulsification. The effect of stretching was significantly greater in eyes with synechias, but no significant differences in post-operative pupil motility was observed between the three subgroups. Six eyes with pronounced postoperative inflammation responded well to antiinflammatory treatment.
  
  
  CONCLUSIONS
  Done with routine surgical instruments, bimanual pupillary stretching seems to be an easy, safe and effective procedure for enlarging small pupils by an average of 2.7 mm during phacoemulsification, especially in eyes with posterior synechias.
authors.affiliation: Department of Ophthalmology, University of Rostock, Germany.
authors.forename: A
authors.initials: A
authors.lastname: Bacskulin
authors.forename: G
authors.initials: G
authors.lastname: Kundt
authors.forename: R
authors.initials: R
authors.lastname: Guthoff
mesh_terms: D000368:Aged; D004106:Dilatation / Q000379:methods; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007498:Iris; D008297:Male; D015878:Mydriasis / Q000188:drug therapy / Q000209:etiology / Q000601:surgery; D009184:Mydriatics / Q000008:administration & dosage; D018918:Phacoemulsification / Q000379:methods*; D011680:Pupil; D016896:Treatment Outcome
chemical_list: D009184:Mydriatics