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This abstract is assigned to session BSCRS 1

Presentation type	Invited
Title	Floppy Iris Syndrome and Narrow pupil in modern Cataract Surgery

Purpose	Small pupil size and intraoperative floppy iris syndrome (IFIS) are among the most frequent intraoperative challenges in cataract surgery, increasing the risk of iris trauma, posterior capsule rupture, and vitreous loss. This invited lecture aims to provide surgeons with a practical, structured framework for recognizing, preventing, and managing these conditions.
Methods	The course combines didactic teaching with video-based case demonstrations. Topics include preoperative risk stratification (e.g. alpha-1 antagonist use, small pupil etiologies), pharmacological strategies for pupil dilation (intracameral mydriatics, viscomydriasis), and mechanical pupil expansion techniques, including iris hooks, pupil expansion rings (Malyugin ring type 1 and 2), and sphincterotomies. Adjustments to phacoemulsification technique in small or floppy pupils are also reviewed, along with approaches to avoiding and managing intraoperative complications.
Results	Attendants are guided through a stepwise decision-making process for device and technique selection based on clinical scenario, supported by illustrative surgical footage highlighting common pitfalls and their solutions. Emphasis is placed on early recognition of IFIS and proactive rather than reactive management.
Conclusion	A systematic approach to small pupils and IFIS, combining appropriate preoperative planning with targeted intraoperative techniques, allows for safer and more predictable cataract surgery outcomes, even in challenging cases.
Conflict of interest	No

Authors 1

Last name	GOES
Initials	F
Department	Goes Eye Centre
City	Antwerp