title: Small Pupil--Big Problem: A Management Algorithm.
abstract: Small pupils pose problems for cataract surgery. The pupil is dilated with topical mydriatic drugs for all cataract surgeries to improve the surgeon's access to, and visualization of, the lens nucleus, cortex, and capsular structures. Limited dilation poses a risk of surgical complications such as iris trauma or tearing of the anterior or posterior capsule. There are many ways and methods to achieve the appropriate pupil dilation, from pre-operative medications to intraoperative pharmacological and/or surgical methods. A management algorithm for small pupil will be discussed in this review. The various methods and maneuvers may work in isolation or combination to achieve adequate pupil dilation.
authors.affiliation: From the *The C-MER (Shenzhen) Dennis Lam Eye Hospital, Shenzhen; and †The State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-Sen University, Guangzhou, People's Republic of China.
authors.forename: Vineet
authors.initials: V
authors.lastname: Ratra
authors.forename: Dennis S C
authors.initials: DS
authors.lastname: Lam
mesh_terms: D000465:Algorithms; D002387:Cataract Extraction / Q000379:methods*; D006801:Humans; D007431:Intraoperative Complications / Q000517:prevention & control; D007498:Iris / Q000601:surgery; D015877:Miosis / Q000175:diagnosis / Q000628:therapy*