In what cases do you consider mannitol for cataract surgery?

I have found IV mannitol VERY helpful for dehydrating vitreous for short axial length, especially around 20.5 or less. Otherwise, in short eyes, there is less working space and a greater tendency for the iris to want to prolapse out, even in the absence of typical IFIS-type medications. I’ve typical...

I consider mannitol in eyes with short axial length <22 mm or shallow anterior chambers (<2.5 mm). I do avoid if any renal disease or congestive heart failure. I start with 12.5 grams and give up to 25 if need be.

Hyperopia, lax zonules, and misdirection syndrome are all helpful with a mannitol "push."

Axial length less than 20 mm is more likely to have shallow chambers, positive vit pressure, thus more difficult rhexis and possibly PCR. Have anesthesia administered as a bolus (not a drip), or it will not be ...