Ring for pupil dilation effective in bimanual cataract surgery

LISBON, Portugal — A new device can be effectively used for pupil dilation in complicated cases of bimanual cataract surgery. The pupil ring is made of PMMA and has a special design with a small loop that captures and stretches the iris during phacoemulsification maneuvers. The ring is inserted through a paracentesis and positioned with a hook.

“Thanks to this ring we obtain a stable 5.5-mm to 6-mm pupil dilation, which is sufficient to safely carry out our surgical maneuvers,” Khristo Takhchidi, MD, said.

Here at the European Society of Cataract and Refractive Surgeons meeting, Dr. Takhchidi reported on 57 cases of cataract complicated by glaucoma, pseudoexfoliation syndrome, diabetes or uveitis that were operated on using a bimanual microincision technique at the Fyodorov Eye Microsurgery center in Moscow. In 25 eyes the pupil expander device was used, while a conventional iris retractor was used in the other 32 eyes.

“Surgery-related complications were fewer in the group of patients where the new expander was used. The ring holds the iris well in place, making surgical maneuvers safe and easy,” Dr. Takhchidi said.

Postoperative endothelial cell counts suggested that the ring provides better endothelial cell protection than conventional retractors. The ring was also associated with less hyphema, fewer fibrinoid reactions and less IOP increase.

The device is not yet commercially available, Dr. Takhchidi said.