Manual Small Incision Cataract Surgery in Small Pupils – A Brief Review

Abstract Cataract surgery in small pupil conditions presents unique challenges and requires specialised techniques for optimal outcomes. Phacoemulsification in pupils of only 3 mm is very challenging, and small incision cataract surgery is still a good to go option for a safer outcome. In small incision cataract surgery for small pupil cases, surgeons employ various approaches to overcome these challenges. One common technique involves using devices or medications to dilate the pupil before surgery. This may include mechanical devices such as pupil expanders or pharmacological agents like intracameral adrenaline or phenylephrine to achieve adequate dilation. This review emphasises surgical tips and context-specific strategies for safe manual small incision cataract surgery in small pupils without using mechanical devices, thereby providing practical insights for surgeons, especially in resource-limited settings.