How to avoid iris prolapse – Takashi Nakano

This is a short video in which Dr. Celso Takashi Nakano (BRAZIL) shows us a very important and simple tip to have better control of the iris in every cataract surgery. Cataract surgery is composed of important details which can make a big difference especially in difficult cases such as IFIS and shallow anterior chamber. Look how Dr. Takashi Nakano with a simple movement can change iris behavior within the main incision.

Transcription:

Hello, I´m Dr. Celso Takashi Nakano from São Paulo Brazil.
Today I will give you a tip on how to avoid iris prolapse during cataract surgery.

Iris does not go out from the eye by itself, there is always someone who pushes it out.

Who is responsible for that? Always the surgeon.

How do we make it happen? Usually, there is too much viscoelastic or BSS inside the anterior chamber. So when we open the incision the iris will come along with the excess of liquid that is coming out.

How can we avoid Iris Prolapse? At the moment we decide to take the instruments out of the eye, we need to do it slowly and we need to push the incision down gently and observe that part of the fluid, generally, BSS will come out from the inferior part of the incision making the tension inside the eye to drop down.

At the moment you must take the instruments outside of the eye keeping the Iris inside the eye.
If you see the Iris is trying to come out with the instrument you can press the incision down a little more.

Sometimes you need to keep the iris inside pushing it with the instrument after the complete remotion has been completed.

It seems like something really simple but it makes a huge difference, to make an easy surgery without pupil fluctuations, so your outcomes will be better.

A big hug to you!