Cataract surgery in the small adult eye: a review

Modern cataract surgery continues to advance, yet intraocular lens (IOL) based surgery in the small adult eye remains challenging. Thorough preoperative assessment and surgical preparation optimise postoperative outcomes in these cases. Advances in IOL power calculation, including artificial intelligence-driven formulas, improve accuracy; however, careful consideration of biometry and IOL power selection is still necessary because inaccuracies can produce significant errors. Limited availability of high-powered IOLs to fully correct high refractive errors may necessitate further intervention. Surgical techniques have evolved to address the unique anatomical challenges of small eyes, improving safety and outcomes. Knowledge of the potential risks inherent in these cases can assist the surgeon in modifying the operative technique accordingly. This review discusses essential preoperative assessments, IOL power selection, surgical techniques, and potential complications, offering guidance for surgeons performing cataract surgery on small adult eyes.