Posters

Advances in small pupil surgical strategy

Poster Details

First Author: K. Kenyon UNITED STATES

Co Author(s):                        

Abstract Details

Purpose:

During anterior segment surgery, the small pupil due to IFIS, pseudoexfoliation etc poses a major challenge. In addition to pharmacologic and viscoelastic agents, mechanical dilation strategies involve iris retraction or pupil expansion devices. To improve the latter approach, we describe the design and clinical results of a novel pupil expansion ring.

Setting:

Academic and private clinical practices conducting cataract and anterior segment surgery

Methods:

The Visitec I-Ring Pupil Expander (BVI, Waltham, MA) is a sterile, single-use polyurethane ring designed to enlarge the surgically inadequate pupil utilizing an insertion-extraction device through a 2.4 mm primary corneal incision. Having both US FDA and CE mark approval, we report its use in small pupil surgical situations, including primary cataract surgery as well as complex intraocular lens (IOL) exchange.

Results:

During more than 100 cases of small pupil cataract surgery performed by six experienced anterior segment surgeons, the I-Ring was reliably inserted and easily removed. Complete 360 degree iris engagement consistently produced a 7.0 mm diameter circular pupil. In cases further complicated by IOL and/or lens capsule dislocation, the I-Ring both enlarged the pupil and stabilized the iris and vitreous to facilitate IOL removal and exchange. The device proved atraumatic to the iris and other ocular tissues, and it was entirely without intrinsic complication. Representative videos will amplify these observations.

Conclusions:

The Visitec I-Ring advances the safety, reliability and consistency of surgical devices for mechanical intraoperative pupil enlargement. It's extensive use in both primary cataract extraction as well as more complex surgical scenarios has been uniformly salutary.

Financial Disclosure:

One or more of the authors receives consulting fees, retainer, or contract payments from a competing company