gms | German Medical Science

Narrow pupil and lens subluxation are most common reasons of complications during phaco. Implantation of Malyugin ring provides good mydriasis but in case of zonular defect there is no possibility to fix the capsular bag and its additional fixation is necessary. Use of iris retractors for capsular bag fixation by capsulorhexis capture is one of such methods. Besides positive moments, use of hooks requires additional incisions, limits surgical maneuvers in the anterior chamber, and may cause defects of capsulorhexis edge in case of incorrect hooks placement.

Purpose: To present a new technique of lens stabilization during phacoemulsification in case of lens subluxation using Malyugin ring.

Methods: Presented technique includes mydriasis achievement using Malyugin ring, capsulorhexis is performed at the edge of enlarged pupil, then the hinges of the ring are replaced capturing both capsulorhexis edge and pupil edge. So, capsulorhexis edge and pupil edge are fixed together by hinges of the ring. The main aim of the suggested technique is fixation of the capsulorhexis to the iris.

Results: The efficacy of the technique is estimated on 62 operations. After intracameral injection of mydriatic pupil diameter was less than 4.2 mm. In all the eyes irido-phacodenesis was present, the lens was in central position. In all cases iridocapsular fixation remained stable till the end of operation. In 7 cases cortex was not completely aspirated due to risk of capsular bag loss, in 3 cases with zonular defect exceeding 180 degrees capsular bag was removed.

Conclusions: The suggested technique provides a possibility of effective phacoemulsification in cases with narrow pupil and lens subluxation