This article is more than 5 years old. Information may no longer be current.
Less operating time needed in Malyugin ring vs. iris hook cases
Both pupil expansion rings and iris hooks are effective when used in patients with small pupils during cataract surgery; however, operating time is faster when pupil expansion rings are used, according to a study.
Data from 425 small pupil cases were evaluated in terms of operating time, intraoperative and postoperative complications, and visual acuity outcomes. Both trainee and consulting surgeons were included in the retrospective case study.
A Malyugin pupil expansion ring (MicroSurgical Technology) was used in 314 of the cases, and 95 cases were managed with five flexible iris hooks (Alcon/Grieshaber)and an ophthalmic viscosurgical device. The remaining 16 cases were managed with pharmacological means and did not require a pupil expander device.
The median operating time for cases without a pupil expander device was 16 minutes for consultant surgeons and 26 minutes for trainees. That increased to a median of 20 minutes for consultants (P < .001) and 32 minutes for trainees (P < .001) in cases in which a Malyugin ring was used and 30 minutes for consultants (P < .001) and 50 minutes for trainees (P < .001) in cases in which iris hooks were used.
“The use of the Malyugin ring for small pupil cases was faster than the use of iris hooks, especially when a trainee is operating,” the study authors wrote.
Cases in which a pupil expander was used did not have a statistically significant difference in mean visual acuity improvement compared with cases that did not use a pupil expander. Those in which an expander was used had an average gain of 0.39 logMAR distance visual acuity, while those without a need for pupil expanders had an average improvement of 0.45 logMAR distance visual acuity.
The Malyugin ring group saw a significantly higher proportion of corneal edema (P < .001) and anterior uveitis (P < .001) postoperatively. Those requiring iris hooks had a higher proportion of raised postoperative IOP, but it was not statistically significant. – by Rebecca L. Forand
Disclosure s : The authors report no relevant financial disclosures.