DOI: 10.36347/sjams.2021.v09i01.013

Pages: 70-73

Dealing with a rigid non dilating pupil in a small incision cataract surgery is challenging, even more so when dealing with a large and a hard nucleus. There is an increased risk of complication in eyes with small pupil (<6mm) during cataract surgery. Loose zonules and hard nuclei maybe missed in small pupils, leading to complications. Aspiration of cortical matter and capsulorrhexis behind the iris in spaces that are not visible to the surgeon can cause an increased risk of complications. In India, where the majority of the people visiting a government tertiary care hospital like ours present with white/hard cataract belong to a lower socio-economic strata, there is a need of an effective and inexpensive method that provides adequate pupillary dilation during cataract surgery. There are various methods described to make the pupil wider during surgery, like iris sutures, Healon 5, iris hooks, mechanical stretching, and ring expanders, which require additional instruments and cost. This is an added burden for the majority of the patients who are of a low socioeconomic status and present late with white/hard cataracts. We decided to study the efficacy and safety of sphincterotomy in white/hard cataracts who underwent SICS in our unit. This study on 20 eyes showed that sphincterotomy is a safe, easy to perform method without any additional cost to obtain an adequate pupil size in small pupils and has excellent postoperative results.