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Clinical experience with novel, hinged, pupil expansion device

Poster Details

First Author: H.Uy PHILIPPINES

Co Author(s):    K. Kenyon   R. Pineda                 

Abstract Details

Purpose:

To report the efficacy and safety outcomes of a new, hinged, pupil expansion device (PED) among eyes with small pupils, undergoing phacoemulsification cataract surgery (PE).

Setting:

Multicenter study. Participating sites are the Peregrine Eye and Laser Institute, Makati, Philippines and New England Eye Center, Boston, Massachusetts

Methods:

Thirty eyes with suboptimal surgical pupil sizes underwent PE. Pupil diameters (PD) were measured using slit-lamp and surgical calipers. Perioperatively, the pupils received dilating drops and intracameral epinephrine. Intraoperatively, a disposable, hinged PED (I-Ring, Beaver Visitec, Waltham, MA) was inserted through a 2.2 mm clear corneal incision, deployed in the anterior chamber and attached to the pupil edges using a pair of Sinskey hooks. PE was then performed. The PED was removed after intraocular lens implantation. Main outcome measures: Rate of successful maintenance of adequate pupil size, complications, and, PD at different time points during the surgical process.

Results:

The PED was successfully applied and maintained adequate surgical pupil size in 30 of 30 eyes (100%). There were no cases of iris tears, prolapse nor bleeding. The mean (SD) PD at different time points were: preoperative, 3.0 (1.0) mm; after dilating drops, 4.3 (0.8); after intracameral epinephrine, 4.4 (0.8); after PED application, 7.0 (0.0); after PED removal, 6.5 (0.8); and at 1 month postoperative visit, 3.5 (0.8). The mean postoperative PD was significantly larger by 0.5 mm compared to the preoperative, undilated pupil (P= 0.03).

Conclusions:

Among eyes with suboptimal pupil dilation undergoing cataract surgery, the hinged PED successfully enlarged the PD�â�€�™s to 7.0 mm in all eyes and maintained visualization of anterior structures throughout the surgery. There were no complications encountered with the use of this device. Postoperative pupil size is generally slightly larger than preoperative pupil size. This hinged PED is a useful and safe addition to the list of available instruments for helping cataract surgeons manage small pupils.

Financial Disclosure:

receives consulting fees, retainer, or contract payments from a company producing, developing or supplying the product or procedure presented

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