IRIS PROLAPSE - WHO - WHEN - WHY

A 12-month period was reviewed to identify the incidence or iris prola pse following cataract surgery, and any predisposing factors. Of 1408 routine manual extracapsular cataract extractions, 29 eyes (2.06%) sus tained an iris prolapse. Iris prolapse was commoner in Asian patients and when less experienced surgeons were operating. Twenty-five per cen t of cases occurred in patients with obstructive airways disease or po st-operative cough. Thirty-four per cent of iris prolapses were identi fied on the first post-operative day and 86% within 2 weeks. Prolapse probably occurs because of raised intraocular pressure in association with poor wound construction or closure. More emphasis should be given to wound construction and closure during surgical training, with extr a diligence when operating on patients likely to cough post-operativel y. Clinicians must ensure non-English speaking patients understand abo ut ocular aftercare following cataract surgery.