Título

EFFICACY OF THE CANABRAVA’S RING PUPIL EXPANSION DEVICE IN CATARACT SURGERY ON EYES WITH SMALL PUPILS: THE FIRST 30 CASES.

Objetivo

Evaluate the efficacy outcomes of the first 30 cataract surgeries performed with a new disposable small-pupil expansion device.

Método

Thirty eyes of 29 patients underwent cataract surgery using a new disposable small-pupil expansion device, Canabrava’s Ring (AJL Ophthalmic, SPAIN) intraoperatively. All eyes had poorly preoperatively dilated pupils of less than 5mm. Fifteen eyes had significant infective or traumatic pathology (e.g. toxoplasmosis, uveitis, and retinal detachment post vitrectomy with silicone oil) preoperatively. Pupil diameters were evaluated before, during and one month after surgery. Intraoperative ring stability and intraoperative and postoperative adverse events were additional outcomes assessed.

Resultado

The mean age of the patients was 64 ± 11.8 (standard deviation [SD]) years (range 35 – 85 years). The ring remained stable and engaged throughout all surgeries except one. All pupils were intraoperatively expanded to achieve a diameter of 6.3mm. T-test revealed a significantly larger mean pupil circumference postoperatively than preoperatively, at 13.3 and 11.7 mm, respectively (p=0.00). Postoperative complications were observed in 8 eyes. There was 1 case of reactivation of toxoplasmosis, retinal detachment, posterior capsule rupture, posterior capsule opacification, 4 cases of posterior synechiae. These complications occurred in eyes with pre-existing traumatic, infective pathology or preoperative synechiae.

Conclusão

The disposable Canabrava’s Ring appears to be effective at expanding and maintaining expansion of small pupils undergoing cataract surgery. Although a postoperative increase in pupil circumference was observed, it is thought that this most likely reflects the effect of pre-existing pathology on the innervation of the pupils, hindering their ability to return to preoperative size regardless of the expansion device used. Further large-scale studies are required to provide additional support for the observations made in this study.