Peer-review started: May 20, 2019
First decision: May 30, 2019
Revised: August 28, 2019
Accepted: October 3, 2019
Article in press: October 4, 2019
Published online: October 16, 2019
Pupil expansion rings are widely accepted as a useful tool in cataract surgery. However, there are no studies that compare different devices or examine in detail the decision to goes into the decision and clinical settings to use the device.
This study examines a new member of this class of device, providing advantages in design over previous devices. It also examines the co-morbidities associated with small pupil in the cataract milieu of 2019.
To document the safety profile and use of I-ring pupil expansion ring in a clinical practice. The study showed a better understanding of the challenges associated with small pupil cataract surgery and hopefully will assist cataract surgeons in dealing with these challenges.
Retrospective review of case series.
A surprisingly high rate of complication and co-morbidities were found in this case series. Further innovations in dealing with zonular dehiscence, posterior capsule rupture, and dense cataracts need to be continually sought after.
I-ring is a useful tool in the armamentarium of cataract surgery. It is less traumatic to the pupil than its predecessors due to its softer material in 360o engagement of the pupil. It helps to maintain pupil dilation in small pupil cases relating to pseudoexfoliation, IFIS and femtosecond laser induced myosis.
This study illustrates that there are still challenges to be met in cataract surgery. Despite the technical advances with phaco fluidics, femtosecond laser, pupil expansion rings, dense cataracts with zonular problems and small pupils are still a challenge for cataract surgeons. Further research and innovations are still needed to address these problems.