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Efficacy of mechanical dilation devices in cataract surgery

Poster Details

First Author: F.Crenguta ROMANIA

Co Author(s):    A. Pantalon                    

Abstract Details


Aim of the study was to assess the efficacy of mechanical dilation devices in cataract surgery, taking into account the frequency of use, type of the device, patient pathology that mandated this approach, intraoperatory particularities and functional results


"Gr.T.Popa" University of Medicine and Pharmacy Iasi, Romania "Sf. Spiridon" University Hospital, Iasi, Romania


We analyzed retrospectively between September 2016-September 2017 all the cataract procedures which were operated by the same surgeon and that required mechanical dilation for small pupil. We included demographic parameters (age, sex) and clinical data related to the degree of lens opacification, cause of insufficient pupil dilation, level of difficulty for the surgical maneuvers (other ocular pathologies, fellow eye status, visual acuity-VA); type of mechanical device that was used, intraoperatory findings (particularities, complications) and functional results were noted also.


37 eyes from 35 patients (4.73%) mandated mechanical devices for small pupil management during cataract surgery.Mean age was 74.02 +/-12.09 years.Small pupil was due to pseudoexfoliation (49%), systemic use of alpha-1 agonists (21%), inflammation (18%), lens subluxation (9%) or other causes (3%). Baseline VA was <0.02 (Snellen, decimal) in 40% eyes, 60% cases having VA<0.1. Mean CDE was 22.26+/-18.16, with phaco-chop as preferred surgical technique (73%) vs divide and conquer (27%). We used 27 iris retractors,4 Malyugin rings and 6 capsular retractors, alongside with additional maneuvers: synechiolysis (3 cases), sphincterotomies (3 cases), CTRs (5 cases), anterior vitrectomy (4 eyes).


Functional results were quantified by the obtained VA at 6 to 8 weeks after surgery.A significant improvement in the final VA was noted 0.58+/-0.1, p<0.001, compared to baseline. Small pupil in cataract surgery remains a challenge for the anterior segment surgeon, but we have shown that by cautious using mechanical dilation devices, the procedure went uneventfully assuring both the surgeon and the patient good functional results.

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