Correlation of pupil diameter and intraoperative complications in patients with pseudoexfoliation undergoing phacoemulsification cataract surgery.

BACKGROUND AND

OBJECTIVE

Study the correlation between pupillary diameter and intraoperative complications in patients with pseudoexfoliation undergoing phacoemulsification.

MATERIAL AND

METHODS

Prospective, observational, and descriptive study. Data were collected from May 2024 to May 2025.

RESULTS

Preoperative pupillary diameter <5.5 mm post dilation was significantly associated with the development of intraoperative complications (P = .002). Among patients with complications, the median pupil dilation was 4.99 mm, whereas in those without complications the median was 5.94 mm. Most complications occurred during the phacoemulsification phase (6; 66.7%), followed by capsulorhexis (2; 22.2%). Additionally, the presence of zonular weakness was significantly associated with the development of complications (P < .001).

CONCLUSIONS

Preoperative identification of a pupil diameter <5.5 mm post dilation may alert the surgeon to potential intraoperative findings such as zonular weakness and iris instability, which may lead to better surgical planning.