A NEW pupil expansion ring can greatly facilitate phacoemulsification in eyes with small pupils, including those with weak zonules, according to the device’s developer,

A NEW pupil expansion ring can greatly facilitate phacoemulsification in eyes with small pupils, including those with weak zonules, according to the device’s developer, Boris Malyugin MD PhD, S Fyodorov Eye Microsurgery Complex, Moscow, Russia. The pupillary ring uses the scroll principle to capture and expand the iris margin.The device is composed of 5-0 polypropylene and is square in shape. It has corners twisted into loops that clasp the edge of the iris and enable the surgeon to stretch the pupil to a width of 6.0mm, with less trauma to the iris than occurs with conventional nonpharmacological techniques, Dr Malyugin told the XXV Congress of the ESCRS. “I use it in all cases of small pupil during phaco including floppy iris syndrome.At the end of the procedure it is removed from the eye.The decision of whether or not to implant the capsular ring as well depends on the laxity of the zonular apparatus of the lens.” In addition, in eyes with zonular weakness the design of the ring also makes it possible to temporarily clamp the edge of the anterior capsulorhexis to the pupillary margin, simultaneously providing a large pupillary aperture and zonular support, Dr Malyugin said.“With this manoeuvre we attach the capsule to the iris thus creating artificial zonular fibres and artificial zonular support.When the capsular bag is suspended with the ring you can perform safe phaco with a chop or whatever technique you will prefer and you can be sure the capsular bag will stay in place.”