Retrospective Cohort Study
Copyright ©The Author(s) 2019. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Ophthalmol. Oct 16, 2019; 8(1): 1-6
Published online Oct 16, 2019. doi: 10.5318/wjo.v8.i1.1
Series of cataract surgeries with I-ring pupil expansion ring
Kenneth Lu, Martin Garcia, Jack Tian, Rustum Karanjia
Kenneth Lu, Martin Garcia, Jack Tian, Rustum Karanjia, Doheny Eye Institute, University of California, Los Angeles, CA 91007, United States
Author contributions: Lu K and Karanjia R designed the study; Garcia M and Tian J collected the data; Lu K prepared the manuscript.
Supported by a research grant from Beaver-Visited International, the manufacturer of the I-ring.
Institutional review board statement: The UCLA Institutional Review Board has approved the above-referenced study.
Informed consent statement: Since this was a retrospective review of cases already performed with no release of any personal information, our institutional review board has waived the need for informed consent of the specific patients.
Conflict-of-interest statement: The authors do not have any financial interest in the company or the device.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See:
Corresponding author: Kenneth Lu, MD, Assistant Professor, Doheny Eye Institute, University of California, Los Angeles, 622 W. Duarte Rd, Suite 101, Arcadia, CA 91007, United States.
Telephone: +1-626-2549010
Received: May 17, 2019
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
Research background

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.

Research motivation

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.

Research objectives

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.

Research methods

Retrospective review of case series.

Research results

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.

Research conclusions

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.

Research perspectives

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.