J Refract Surg. 2013 Dec;29(12):858-62. doi: 10.3928/1081597x-20131115-06.
To describe methods for performing laser-assisted cataract surgery in small pupils.
Iris retractors or a Malyugin Ring (Microsurgical Technology, Redmond, WA) were used for mechanical pupil dilation before laser capsulotomy and lens fragmentation. The laser treatment can be performed with or without use of ophthalmic viscosurgical devices (OVD).
In 73 eyes with small pupils, laser treatment was possible after mechanical dilation device installation. With and without an OVD, no flattening of the anterior chamber or other complications occurred during re-docking, laser treatment, or the manual part of the operation. Small adhesions of the anterior capsulotomy were more frequent when the anterior chamber was still filled with the OVD and did not occur when the OVD was removed.
A small, poorly dilating pupil constitutes a major challenge in cataract surgery, particularly when performing capsulorhexis. Femtosecond laser treatment can be employed with considerable benefit for the patient, even in these difficult cases.
描述在小瞳孔中进行激光辅助白内障手术的方法。
在激光囊切开和晶状体粉碎术前，使用虹膜拉钩或 Malyugin 环（微外科技术公司，雷蒙德，华盛顿州）进行机械性瞳孔扩张。激光治疗可以在使用或不使用眼用粘弹剂（OVD）的情况下进行。
在 73 只小瞳孔眼中，安装机械扩张装置后可以进行激光治疗。无论是否使用 OVD，在前房重新对接、激光治疗或手术手动部分过程中，均未出现前房变平或其他并发症。当前房仍充满 OVD 时，前囊切开处的小粘连更为常见，而当 OVD 被移除时则不会发生。
小而难以扩张的瞳孔是白内障手术的主要挑战，尤其是在进行囊膜切开术时。即使在这些困难的情况下，飞秒激光治疗也可以为患者带来显著的益处。
