Aim — to develop a differentiated approach to hybrid phacoemulsification (PE) in small pupils. Material and methods. Modified hybrid PE was performed in 119 patients (130 eyes) with conditionally small pupils (preoperative dilated pupil diameter of less than 5.5 mm). Results. A differentiated approach to hybrid PE has been developed and tested in patients with poor preoperative mydriasis. Conclusions. Small rigid pupils are considered a relative contraindication for hybrid PE. Developed modifications enable less surgical trauma and changes in efficient exposure time, while the latter is usually increased in standard PE in patients with poor preoperative pupil dilation.