Edema macular cistoide secundario al uso de retractores de iris en la cirugía de la catarata con dilatación pupilar insuficiente

Resumo

Pupil size is of crucial importance in cataract surgery, because insufficient pupillary dilation (<5 mm) is associated with numerous complications by making all stages of phacoemulsification difficult.It is known that diabetic patients and patients with pseudoexfoliation syndrome usually have dilation problems, but the phenomenon has multiplied after the introduction of tamsulosin for the treatment of prostate hypertrophy, since it was observed that these patients, when undergoing cataract surgery, presented insufficient mydriasis and a loss of iris tone, which was named as “intraoperative floppy iris syndrome” or IFIS syndrome.To deal with insufficient pupillary dilation, one of the most popular techniques is the use of iris retractors. The drawback is that, when pulling the iris, micro-ruptures of the pupillary sphincter can be caused, which added to the usual inflammation of surgery, produces a great release of numerous pro-inflammatory factors, which diffuse into the aqueous and vitreous after manipulation and surgical trauma of the iris...