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Clinical results of phacoemulsification with Malyugin ring or manual iris stretching with hooks in eyes with narrow pupil

Poster Details

First Author: K.Eltutar TURKEY

Co Author(s):    T. Alpar Akcetin   B. Karini                 

Abstract Details


To evaluate and compare the results of phacoemulsification with Malyugin ring and manual iris stretching with hooks in eyes with insufficient mydriasis.


İn this retrospective study we evaluated 45 eyes of 40 patients with insufficient pupillary dilatation who underwent phacoemulsification surgery at İstanbul Research and Training Hospital between years 2000-2013.


This study enrolles 45 eyes of 40 patients with insufficient pupillary dilatation.Male/Female ratio was 24/16.The mean age of the patients was 47,8 ± 12,5 years.The study group was made of: 16 patients with pseufoexfoliative sendrome,12 patients with seclusio pupillae secondary to uveitis,6 patients with Diabetes Mellitus,2 patients with intraoperative floppy iris syndrome. 18 eyes of 16 patients were dilated using the Malyugin ring(Group1) and 27 eyes of 24 patients were dilated manually using iris hooks(Group2).Patients were examined preoperatively,1 day, and 1 month after the surgery.Best-corrected visual acuity (BCVA), intraocular pressure, anterior and posterior segment of the eye were evaluated.


The mean intraoperative pupil dilatation which was less than 4 mm was measured as 5.4±0.5 mm when stretched manually with iris hooks,and approximately 6mm when dilated using Malyugin ring.Uncomplicated phacoemulsification and intraocular lens implantation inside the capsule was performed to all the eyes with adequate pupillary dilatation.İris sphincter rupture developed in 17 patients of group 2.In the eyes of group 1 was observed that the pupil retains its round shape.The mean pre-operative BCVA was 1.38 ± 0.48 logMAR Unit and the mean post-operative BCVA (1 months after surgery) was 0,33± 0.18 logMAR Unit in Group 1 and 0.41 ± 0.23 logMAR Unit in Group 2. In both groups there was a significant improvement in BCVA after the surgery (p˂0.05).


During phacoemulsification in eyes with inadequate dilatation, Malyugin ring implantation is a simple,safe and fast alternative when compared with manual iris stretching. It provides a round dilated pupil without traumatizing it and it does not require additional incisions. However, manual iris stretching with hooks requires at least 4 additional incisions.

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