Dr.Rohit Om Parkash, Dr.Shruti Mahajan
This video presents challenges faced in fragile small pupil phacoemulsification despite using pupil expansion devices. Under topical anaesthesia a 2.8 mm temporal incision was made. Malyugin ring was injected under viscoelastic into the anterior chamber. During placement of the scrolls, one of the lateral scrolls slipped under the iris leaving a D shaped iris and poor pupil expansion. Iris hooks were used to expand the pupil completely. Due to poor staining of anterior capsule, capsulorhexis was completed with difficulty. Phacoemulsification was completed by direct chop method and in the bag IOL implantation was done. During ring removal, Iris prolapse was encountered which was dealt with minimal manipulation.