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Efficacy and safety of an injector-free preloaded delivery system for the new B-HEX pupil expander

Poster Details

First Author: S.Bhattacharjee INDIA

Co Author(s):                        

Abstract Details


To evaluate the efficacy, safety and preservation of sterility of an Injector free preloaded delivery system used for the new design 3rd generation B-HEX Pupil Expander (Bhattacharjee ring).


Nayan Eye Centre, Kolkata, India.


The B-HEX Pupil Expander (Med Invent Devices, India), is a single use flexible joint-less hexagonal ring with a 0.075 mm profile having notches and flanges disposed in a single plane. Each disposable 6.5 mm B-HEX provides a 5.5 mm expanded pupil. It is preloaded in a single use carrier which delivers the device sterile at the incision. The device was inserted, engaged to the pupil margin and removed using a 23 gauge forceps. Rigid non-elastic pupils were stretched before placement of the device. Ease of use and safety were noted from videos. Post-operative records were checked for TASS or endophthalmitis.


32 eyes with pupils 5 mm or less underwent pupil expansion with the B-HEX Pupil expander followed by phaco emulsification. 7 eyes with intraoperative miosis after capsulorhexis underwent pupil expansion with the B-HEX. The B-HEX was easily slid into the eye from the preloaded carrier, preserving sterility, using a 23 gauge forceps. 1.5 mm or larger incision was preferred for insertion. The B-HEX could be removed through a 1 mm incision. Placing viscoelastic under the pupil margin and keeping the anterior chamber under-filled helped tucking the flanges. No complications were noted. No incidence of TASS or endophthalmitis was noted.


The preloaded carrier and uniplanar B-HEX design allow easy, safe and sterile implantation and engagement using a 23 gauge forceps even after capsulorhexis, through very small incisions. Pupil expanders with biplanar scrolls or pockets snag the slit corneal incision and have a thick profile requiring an Injector to circumvent this. The Injector does not provide any advantage towards preservation of sterility. While the device may be delivered sterile, the exterior of the injector tube contacts the external lips of the incision and conjunctiva and then enters the eye. The tube occupies precious incision space and precludes visibility of the device.

Financial Disclosure:

gains financially from product or procedure presented

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