Really. This is not an exaggeration. If you understand the physics of why the iris is prolapsing through the incision, you will be able to fix it in just about 2 seconds.
The patient has a history of tamsulosin (Flomax) use and that has induced floppy iris syndrome and less than optimal pupil dilation. When we perform hydro-dissection, there is a build-up of fluid in the lens capsular bag, which in turn pushes the iris forward. We end up with high pressure behind the iris and low pressure in front of the iris. This pressure gradient causes the iris prolapse.
As soon as we see this iris prolapse, we use the 27g cannula to lift the cataract up in order to allow the trapped balanced salt solution to exit the capsular bag. This instantly neutralizes the pressure gradient and the iris prolapse resolves on its own without further manipulation.
