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The Surgical Result of Phacoemulsification Cataract Surgery according to Pupil Size

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Purpose: To evaluate surgical results of phacoemulsification cataract surgery with respect to pupil size and iris retractors and to compare the effects of iris retractors according to the pupil size. Methods: This retrospective study included 90 eyes that underwent phacoemulsification cataract surgery. All of the eyes had a maximally dilated pupil size of 7 mm or smaller. Results: When the patients were evaluated according to pupil size, we found no difference in BCVA (best-corrected visual acuity) and phaco power × time between patients who had surgery involving iris retractors and those who did not. However, in patients with pupil sizes 3 mm or smaller, we did observe a statistically significant decrease in endothelial cell density (CD) when the iris retractor was used compared to when the retractor was not used (p<0.05). A comparison of preoperative and postoperative BCVA measurements revealed a significant BCVA increase in eyes with pupils larger than 3 mm. In contrast, in eyes with pupils smaller than 5 mm, significant decreases in CD were found when the preoperative and postoperative measurements were compared. Conclusions: In this study, we found that the iris retractor is useful for protecting corneal endothelial cells when the pupil size is smaller than 3 mm.

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