Pupil-expansion ring implantation through a 0.9 mm incision

Disposable square and hexagonal Bhattacharjee pupil-expansion rings are made of 5-0 nylon, have notches at the corners, and flanges at the sides in a single 0.1 mm thin plane. To insert the ring, a flange is held with a 23-gauge forceps and the ring is inserted through a 0.9 mm (20-gauge) or larger main- or side-port incision. Alternate flanges are tucked under the iris using a Kuglen hook. A 23-gauge forceps and an iris hook can also be used to tuck the flanges bimanually. The ring is removed by disengaging 2 notches and pulling it out of a 0.9 mm (20-gauge) incision. No snagging of the incision occurs at insertion or removal. No injector is required. The device is useful in standard coaxial phacoemulsification, femtosecond laser–assisted cataract surgery, biaxial microincision cataract surgery (MICS), coaxial sub-2.0 mm MICS, and small-pupil microincision vitreous surgery and in eyes with shallow anterior chambers.Financial DisclosureDr. Bhattacharjee has a pending international patent application (PCT-WIPO) for the pupil-expansion devices.