title: A self-made disposable iris retractor in small pupil phacoemulsification.
abstract: OBJECTIVE
  To explore a simple and low-cost self-made disposable flexible iris retractor and study its clinical efficacy and safety in small pupil phacoemulsification.
  
  
  METHODS
  Polyproplyene suture and scalp acupuncture were used to make iris retractor. A prospective study were carried on 50 patients (50 eyes) with a maximally dilated pupil size of 2.5-4.0 mm which underwent phacoemulsification using this self-made iris retractor. Another 50 cases of phacoemulsification with normal pupil size sever as control group. The mean operation time, ultrasound time and ultrasonic power, volume of irrigation fluid were documented intraoperatively. The visual acuity, pupil size and complication were observed on 1d, 1wk, 1mo and 1y after operation. Corneal endothelial cell was measured at 1mo postoperatively.
  
  
  RESULTS
  Pupils could be expanded to approximately 4.5-5.5 mm with our self-made iris retractor in operation. No serious postoperative complication was found. Most (88%) of the pupils returned round or oval shape, light reflex restored to varying degrees at the first day after surgery. Best corrected visual acuity stabilized in 37 eyes (74%) at one day, in 43 eyes (86%) at one week, in 44 eyes (88%) at one month and 46 eyes (92%) at one year. Compared with the control, more time was needed to complete the operation in the small pupil group. There was no significant difference of the mean ultrasound time, ultrasonic power, volume of irrigation fluid required and corneal endothelial cell loss in 1mo follow up between the two groups.
  
  
  CONCLUSIONS
  Our self-made disposable flexible iris retractor could be easy obtained preoperatively or intraoperatively. It performed both safety and efficacy in our clinical trials. This simple self-made device has shown economic and practical values, especially in primary care hospital of the less developed districts.
authors.affiliation: Department of Ophthalmology, West China Hospital, Sichuan University, Chengdu 610041, Sichuan Province, China ; Department of Ophthalmology, Nanhai Hospital, Southern Medical University, Foshan 528200, Guangdong Province, China.
authors.forename: Jie
authors.initials: J
authors.lastname: Li
authors.affiliation: Department of Ophthalmology, Nanhai Hospital, Southern Medical University, Foshan 528200, Guangdong Province, China.
authors.forename: Fei
authors.initials: F
authors.lastname: Liu
authors.affiliation: West China School of Medicine, Sichuan University, Chengdu 610041, Sichuan Province, China.
authors.forename: Wei-Wei
authors.initials: WW
authors.lastname: Zhang
authors.affiliation: Department of Ophthalmology, West China Hospital, Sichuan University, Chengdu 610041, Sichuan Province, China.
authors.forename: Jun-Jun
authors.initials: JJ
authors.lastname: Zhang
keywords: iris retractor; phacoemulsification; small pupil