Post-operative iris prolapse following phacoemulsification and extracapsular cataract surgery

PURPOSE: This study retrospectively compared and contrasted iris prolapse occurring following extracapsular cataract extraction and phacoemulsification.

METHODS: The clinical notes of all patients who had undergone iris prolapse repair in the last 5 years at Southampton Eye Unit were recalled. Sixty-five patients (mean age 73 years; 41.6% male, 58.4% female) were identified out of a total of 7252 cataract operations performed (5983 extracapsular, 1269 phacoemulsification).

RESULTS: Fifty-nine (93.3%) iris prolapses occurred following extracapsular surgery (83% had corneal incisions, 17% limbal). We identified 3 cases of phaco-related prolapse each of which occurred where the scleral tunnel had been extended to enable insertion of a 7.0 mm optic intraocular lens but had not been sutured. Overall, the average best corrected visual acuity achieved was 6/9.

CONCLUSION: The authors conclude that although iris prolapse is much less common following phacoemulsification, all scleral sections that are extended should be sutured.