Purpose:

To demonstrate possible causes of the Iris Prolapse during phacoemulsification and evaluate distinct forms of surgical management in order to solve this complication with minimal iris trauma.

Methods:

From January 2010 until July 2016, 28 cases of Iris Prolapse of 23 patients occurred during cataract surgery using Phacoemulsification of over 3,000 surgeries. In 5 patients this complication occurred bilateraly, and in one eye of 18 patients. The surgeries were performed by the author. I evaluated the possible causes of each Iris Prolapse and how I managed those cases.

Results:

In 12 eyes, the prolapse was due to Floppy Iris in patients using Tamsulosine, despite the use of Atropine preventively ( 2 bilateral). In 10 eyes, the main cause was Glaucoma ( 2 bilateral), and in 6, they were short eyes (1 bilateral). In relation to the management, 10 eyes needed only a single reduction maneuver, 6 a complex and multi maneuvers, and in 12 eyes a Pars Plana Vitrectomy was required.

Conclusions:

Iris Prolapse has multiple causes, and different forms of management are needed according to each case. Surgeons must recognize the prolapse when it occurs, and apply the proper handling, considering the difficulties, trying not to cause an extensive Iris damage.