This article is more than 5 years old. Information may no longer be current.
Ring device, iris hooks, pupil stretching can assist in cataract surgery in eyes with small pupils
Click Here to Manage Email Alerts
SAN FRANCISCO — Several techniques can be used to perform successful cataract surgery in eyes with small pupils.
At the joint meeting of the American Academy of Ophthalmology and the Pan-American Association of Ophthalmology, Thomas A. Oetting, MD, said he mainly uses the Malyugin ring (MicroSurgical Technology) in small pupils. In addition, it is a good device for patients on alpha blockers and those with narrow fissures, he said.
He recommended not using it in extracapsular conversion or complex cases and said there is a learning curve with the ring.
Iris hooks are a good choice for complex cases, extracapsular conversion and those with shallow chambers, Dr. Oetting said. However, they should be avoided in cases with blebs and narrow lid fissures.
Dr. Oetting said pupil stretching is an effective technique for synechiae and pilo-pupil cases but should not be used in patients on alpha blockers and those with shallow chambers. He recommended that in stretched eyes with ample viscoelastic, "be very careful, particularly during hydrodissection, that you don't get prolapse in the iris."
"What you want to do is remove a little bit of this viscoelastic before you do hydrodissection," he said.