Managing Challenging Pupils Using A Pupil Expansion Ring In A Post-Traumatic Eye

To highlight the usefulness of the Canabrava Ring as an effective pupil expansion device for managing challenging pupils, particularly in post-traumatic eyes with anterior synechiae and altered anterior segment anatomy.

Centro Oftalmologico de Minas Gerais

A 35-year-old male with a history of penetrating ocular trauma involving the cornea, iris, and crystalline lens presented for cataract surgery. The trauma resulted in severe pupillary distortion, extensive anterior synechiae, and a shallow anterior chamber, making pupil management a critical surgical challenge.

After careful synechiolysis, a Canabrava Ring was implanted to achieve stable and adequate pupil dilation. The device provided excellent exposure of the surgical field and maintained pupil stability throughout all surgical steps, allowing safe cataract extraction and successful posterior chamber intraocular lens implantation. The ring remained stable intraoperatively and was easily removed at the end of the procedure. No intraoperative complications were observed.

Postoperatively, the pupil remained stable with good centration. At one-year follow-up, the intraocular lens was well positioned, anterior chamber anatomy was preserved, and no late complications were noted.

Managing challenging pupils is a key step in complex cataract surgery, particularly in post-traumatic eyes. The Canabrava Ring proved to be a highly useful and effective device, providing excellent intraoperative stability and facilitating safe and controlled surgery with favorable long-term outcomes.