2020–2021 BCSC Basic and Clinical Science Course™
11 Lens and Cataract
Chapter 10: Intraoperative Challenges in Cataract Surgery
Anterior Segment Complications
Lens–Iris Diaphragm Retropulsion Syndrome
Lens–iris diaphragm retropulsion syndrome (LIDRS) is characterized by posterior displacement of the lens–iris diaphragm with a marked deepening of the anterior chamber, posterior iris bowing, and pupil dilation. It occurs more commonly in highly myopic eyes and in eyes that have undergone previous vitrectomy. LIDRS results from a high level of infusion pressure in the anterior chamber with a reverse pupillary block; it may cause stress on the zonular apparatus and considerable discomfort for patients under topical anesthesia. Surgery may be more difficult in eyes with LIDRS due to the excessively deep anterior chamber. Lifting the iris off the anterior capsule is usually sufficient to break the pupillary block and restore normal anterior chamber depth. LIDRS is also discussed in Chapter 12 in the section Conditions Associated With Extremes in Axial Length.
Excerpted from BCSC 2020-2021 series: Section 11 - Lens and Cataract. For more information and to purchase the entire series, please visit https://www.aao.org/bcsc.