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Surgeons offer tips on how to use ring device in pseudoexfoliation cases

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Terry Kim

WAILEA, Hawaii — Several surgeons here shared their experience with the Malyugin ring in pseudoexfoliation cases and encouraged other surgeons to employ the device when needed in surgery.

"The Malyugin ring is spectacular. If you haven't used it, you will love it," Roger F. Steinert, MD, said at Hawaiian Eye 2009.

Terry Kim, MD, showed a video of his technique in pseudoexfoliation cataract surgery through a 2.2-mm incision.

Dr. Kim said he inverts the ring when inserting it to prevent the edge of the ring from catching on the incision.

"One pearl is if you are using it with microincision, flip the insertion cannula upside down to get into the wound, and then you can turn it right side up," he said.

Richard L. Lindstrom, MD, added, "They're pretty easy to put in, but be really careful when you are taking it out, and do it very slowly and watch carefully because it is easy to catch the iris with one of the loops."

"When I put it in at that last minute with that last loop that's going to be subincisional, I rotate to the side a little bit," Dr. Steinert said. "Then when you go across with your phaco, you are not bumping into it quite so much."