Effect of cataract surgery using iris retractor on corneal endothelium and anterior segment parameters in patients with non-dilated pupils

Aim: To evaluate the outcomes of cataract surgery performed using flexible iris retractor hooks (FIRHs) in patients with non-dilated pupils and assess the effects on corneal endothelium and anterior segment parameters. Materials and Methods: This retrospective study included patients with non-dilated pupils who underwent cataract surgery using FIRHs. Their best-corrected visual acuity (BCVA), intraocular pressure (IOP), anterior chamber depth (ACD), aqueous depth (AD), central corneal thickness (CCT), and endothelial cell density (ECD) were recorded preoperatively and postoperatively. Results: This study included 32 eyes from 30 patients. The mean IOP (p = 0.307) and CCT (p = 0.149) did not differ significantly between the preoperative and postoperative measurements. However, BCVA, ACD, and AD increased significantly from preoperatively to postoperatively, while ECD significantly decreased (all p < 0.001). Conclusion: FIRHs can be safely used for pupil dilation during cataract surgery on patients with small pupils and provide favorable surgical outcomes for both patients and surgeons.