Posters

Comparison of pupil expanders: Morcher, Malyugin Ring, I-Ring, Oasis, APX and iris hooks during phacoemulsification in patients with small pupils

Poster Details

First Author: M.Petrova BULGARIA

Co Author(s):                        

Abstract Details

Purpose:

To compare the efficiency and easiness of implantation/explantation of variable pupil expanders during phacosurgery in patients with small pupils. We introduced into everyday clinical practice the following pupil expanders – Morcher, Malyugin Ring, I-Ring, Oasis, APX and iris hooks.01.10.2017 -01.10.2018. For the period of one year - 01.10.2017 -01.10.2018, we applied pupil expansion devices to a total of 43 patients.

Setting:

We applied Morcher’s Pupil dilator in 10 patients;The Malyugin ring - in 9 patients; APX pupil expander – in 3; BVI (I-Ring) and Oasis expanders – in 2 patients respectively. The iris hooks were used in 16 eyes. All operations took place UH “Queen Joanna-ISUL” in Sofia.

Methods:

We injected the pupil expanders before the capsulorhexis, after filling the anterior chamber with cohesive and dispersive viscoelastic /soft shell technique/.Whenever it was necessary, we performed viscodissection of posterior synechiae. After sufficient pupil dilatation, we proceeded with the usual stages: rhexis; hydrodissection; phaco- stop & chop; irrigation/aspiration; filling with dispersive viscoelastic. Afterwards we explanted the dilatator and carried on with IOL implantation. The iris hooks were explanted after IOL implantation.

Results:

We did not observe any intra- or postoperative complications of the pupil expanders. While using BVI (I-Ring) and Oasis expanders we encountered difficulties during the implantation/explantation. In addition to the clumsy manipulation, they preoccupied the anterior chamber and lead to insufficient space for phacoemulsification. Malyugin and Morcher rings proved to be most user-friendly and were very elegantly implanted and removed later on. Iris hooks required the longest time for implanting/explanting.

Conclusions:

The application of the pupilexpanders is a useful and safe method for pupildilatation during phacosurgery. Their reasonable use did not lead to any unpredictable complications. However their application requires skills, thoughtfulness and good assessment. Most user-friendly proved to be Malyugin and Morcher rings, while I-ring and Oasis expanders were uneasy to manipulate and diminished significantly the anterior chamber space.

Financial Disclosure:

None