How do you manage small deep set eyes during cataract surgery?

Not a problem: Cataract surgery has evolved so that all the surgery is done from the side instead of over top of the forehead as was done in the past. This direction allows full access so that the surgery can be accomplished successfully and the deepness of the eyes is not a problem.

Cataract surgery: Deep set eyes used to be rather difficult to do when my surgical technique involved incision formation underneath the upper eyelid in the white to clear junction of the eye (limbus). Now my technique has shifted to the lateral side of the eye through a clear corneal incision. This helps by avoiding the prominent superior orbital rim (eye brow area) and allowing better access to the eye.

Not big issue: For experienced skilled surgeons, small deep set eyes are not usually an issue. Rarely, a retrobulbar block can be utilized to bring the eye forward and allow easier access to the eye. A thick viscoelastic such as Healon 5 can be useful for small eyes as well.