Iris alteration using mechanical iris retractors

Abstract

A 74-year-old woman had a 3-port pars plana vitrectomy for a dropped nucleus after complicated phacoemulsification. Flexible nylon iris retractors were positioned to dilate the small pupil. The patient died of a pulmonary embolus 1 day after surgery. The eyeball was removed at autopsy, and pathology of the iris was investigated. Localized damage to the iris where the retractor hooks were positioned was noted, but no other alterations to the iris were observed. These findings may explain the recovery of pupil function that is common after surgery with mechanical iris retractors.

Mechanical dilation of the pupil and its possible applications in femtosecond laser-assisted cataract surgery

“…Гистологическое исследование радужной оболочки после использования ирис-ретракторов во время факоэмульсификации показало ее минимальные гистоморфологические изменения, что говорит о незначительном механическом воздействии на сфинктер радужки [18]. Тем не менее для обеспечения максимально эффективной позиции ирис-ретракторов требуется формирование дополнительных роговичных разрезов под определенным углом к радужке.…”

Modified Malyugin ring iris expansion technique in small-pupil cataract surgery with posterior capsule defect

“…Numerous techniques to enlarge the intraoperative pupil size have been devised. [1][2][3][4][5][6][7][8][9] Recently, Malyugin devised a new iris expander that can pass through a 2.2 mm clear corneal incision. 10 The square-shaped transitory implant has 4 circular scrolls that hold the iris at equidistant points, which provides balanced stretching and gentle control of the iris tissue.…”

Vitrectomy: when things go wrong

“…Intraoperative miosis can be adequately managed by the use of epinephrine solution without preservatives either intracamerally (0.1 ml of 1:10,000) or in the infusion fluid [61,62], or by the use of flexible nylon iris retractors [63][64][65] or silicone rings [66]. Sphincterectomy may be used as a final resort [67].…”