New surgical strategies in pupil expansion

Session Details

Session Title: Cataract Surgery Complications Management. OVDs, Cataract Surgery Equipment

Session Date/Time: Monday 07/09/2015 | 08:00-10:00

Paper Time: 08:18

Venue: Main Auditorium

First Author: : K.Kenyon USA

Co Author(s): :    J. Hughes   E. Lee   D. Cote   S. Moreira           

Abstract Details

Purpose:

During cataract and other anterior segment surgery, management of the small pupil due to intraoperative floppy iris syndrome (IFIS), pseudoexfoliation and other etiologies is a significant challenge. Although pharmacologic and viscoelastic agents are useful, the predominant mechanical dilation strategy involves iris retraction or pupil expansion devices. To improve on these approaches, we describe the design, laboratory and clinical results of a novel pupil expansion ring.

Setting:

Surgical research laboratory utilizing simulated models and human cadaver eyes; and multicenter evaluations during human ophthalmic surgery. Beaver-Visitec International and Massachusetts Eye & Ear Infirmary, Boston, MA, USA

Methods:

The BVI Visitec® I-Ring™ Pupil Expander is a sterile, single-use, polyurethane ring that is designed to safely expand the pupil. The I-Ring is introduced and removed from the anterior chamber utilizing a customized insertion device through a 2.4 mm primary corneal incision. A Sinskey hook is used to engage and disengage four ring pockets to the iris. Clinical evaluations with simulated models and human cadaver eyes, as well as small pupil cataract surgery were performed to assess performance characteristics with respect to safety, efficacy and ease of use.

Results:

Evaluations were completed by six anterior segment surgeons, each experienced with small pupil management. Laboratory testing demonstrated that the device provided acceptable time to insert and remove, and provided consistent pupil engagement and enlargement. During small pupil cataract surgery, the I-Ring proved to be atraumatic to the iris and other ocular tissues, and it was readily inserted and easily removed. Complete 360⁰ iris engagement consistently produced a circular 7.0mm diameter pupil.

Conclusions:

The newly designed BVI Visitec® I-Ring™ Pupil Expander (Beaver-Visitec International, Waltham, MA, USA) advances the safety, reliability and consistency of surgical devices for mechanical intraoperative pupil enlargement.

Financial Interest:

One of the authors is employed by a for-profit company with an interest in the subject of the presentation, One of the authors receives consulting fees, retainer, or contract payments from a company producing, developing or supplying the product or procedure presented