In the recent case report by Osher et al., a new clinical sign is highlighted along with a description of the mechanism of lens-iris diaphragm retropulsion syndrome (LIDRS). I would like to describe a series of maneuvers I have used in the past few years to prevent LIDRS in patients at risk, such as those with high myopia and those with vitrectomized eyes.Having established that an eye may be at risk for developing LIDRS; these steps can be used:1. The scrub nurse is asked to lower the bottle height to about 45 cm.2. The phaco tip and sleeve are pushed into the eye with the irrigation off.3. A side-port instrument (I use a Mackool iris reposi-tor [Duckworth & Kent Ltd]) is pushed through the side port, passed across the eye, and placed under the iris to lift it gently.
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