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Correction: Management and outcomes of the small pupil in cataract surgery: iris hooks, Malyugin ring or phenylephrine?

  • Shafi Balal
    ,
  • Ahmed Said Jbari
    ,
  • Rynda Nitiahpapand
    ,
  • Erica O'Mahony
    ,
  • Wasim Akhtar Akhtar
    ,
  • Nizar Din
Research Output:
Contribution to journal
Article
 Peer-review

Open access

Abstract

Purpose To investigate outcomes for small versus large pupils in cataract surgery using different pupil expansion techniques. Methods Retrospective case-series reviewing 20,175 patients’ cataract surgery electronic medical records at Moorfields Eye Clinic in Bedford Hospital NHS Trust from January 2010 to April 2020. Outcomes such as visual acuity (VA), intraocular pressure, intraoperative, post-operative complications were recorded and small pupil expansion device outcome. Results One thousand, four hundred twenty-six patients were identified as having small pupil (SP). Of these, 1110 patients (77.8%) had interventions to expand the pupil including 447 (31.3%) with intracameral phenylephrine (IC PE) alone, 194 (13.6%) with iris hooks and 469 (32.9%) with a Malyugin ring. The large pupil (LP) group had a statistically significant greater gain in VA than the SP group (p < 0.05). SPs had a significantly higher rate of intraocular complications including posterior capsular rupture (PCR) with vitreous loss (OR 2.75, p < 0.001). There was also a significantly higher rate of post-operative complications such as corneal oedema (OR 2.64, p < 0.001) and anterior uveitis (OR 2.11, p < 0.001) in the SP group. However, VA improvement and complications between the different pupil expansion groups showed no significant differences (p > 0.05) except for a greater rate of iris tears in the Malyugin group (p < 0.05). Conclusion To date, this is the largest reported case-series comparing Malyugin rings and iris hooks with other pupil expansion techniques. The various techniques to expand pupil size appear to be safe and equally effective in improving VA with a similar rate of complications except for a greater rate of iris tears with Malyugin ring.

Publication Information

Output type

Research Output:
Contribution to journal
Article
 Peer-review

Original language

English

Article number

2909

Pages from-to (Number of pages)

Pages 2714-2718

Journal (Volume, Issue Number)

Eye (Basingstoke) (Volume 35)

Publication milestones

  • Accepted/In press - 30/10/2020
  • Published - 12/11/2020

Publication status

Published - 12/11/2020

ISSN

0950-222X

Publication IDs

  • handle.net: 10547/625456
  • Scopus: 85111680080

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