injector system for easy placement and removal through a 1.8mm-inci-
sion. He also points out that its 8 points of fixation create an octagon-
shaped opening with an even stretching of the pupil. Rounded, blunt
eyelets make inadvertent capsule tears less likely during placement.
Additionally, research headed by renowned cataract surgeon David
Chang, MD, showed the ring safely and reliably maintains pupil diam-
eter with minimal iris trauma in patients with intraoperative floppy
iris syndrome.
• I-Ring Pupil Expander (Beaver-Visitec). The I-Ring is made of pli-
able polyurethane material that's inserted into the anterior chamber to
expand the pupil to a circular shape 6.3mm in diameter. Research has
shown that the I-Ring's design and soft material create a stable opera-
tive field and cause minimal distortion to the pupil. Dr. Hamilton says
the device in intuitive to use, but slightly more difficult to maneuver
than the Malyugin ring.
"It demands a sequential approach to circumferentially engage the
iris, and that makes it a bit more challenging," he says. "It's also a bit
bulkier, and the extra mass demands extra caution to prevent it from
coming in contact with the cornea."
• Iris Expander (Oasis Medical). This device, which is available in
6.25mm- and 7mm-diameter sizes, comes with a single-use injector
system that's placed into the anterior chamber under viscoelastic.
Surgeons then manipulate each of the device's eyelets to engage the
edge of the iris and create a large pupil dilation.
• XpandNT Iris Speculum (Diamatrix). The XpandNT comes pre-
loaded in a specially designed injector with a tip designed to easily
guide and release the speculum into place through a 2.4mm-incision.
It has 8 points of contact that are designed to limit trauma to the iris
rim while creating 6.7mm dilation for improved access to the anterior
segment of the eye.
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