3-Step treatment efficient for small pupils

According to recently published data, a 3-step treatment protocol is an efficient way to ensure good safety margins for patients with pupils smaller than 5.5 mm undergoing femtosecond laser-assisted cataract surgery.

The study, led by Dr Ina Conrad-Hengerer (Center for Vision Science, Ruhr University Eye Hospital, Bochum, Germany), examined eyes with an intraoperative pupil size smaller than 5.5 mm to evaluate the efficacy of a 3-step treatment to achieve larger pupil sizes before femtosecond laser-assisted cataract surgery. This 3-step process consisted of initially administering intracameral epinephrine solution, then using additional viscomydriasis and thirdly implantation of a Malyugin ring pupil expander.

Out of 850 eyes that were scheduled to receive cataract surgery, 40 underwent the sequential treatments for pupil expansion. Of this group, 7% only required the first step to achieve a pupil size larger than 5.5 mm, 25% required additional voscomydriasis and 68% needed the pupil expander as well. The team found that the most frequent comorbidities were pseudoexfoliation of the lens capsule (30%) and intraoperative floppy-iris syndrome (12.5%).

Based on this study, it was deemed that the 3-step treatment allowed an increased efficiency and safety of femtosecond laser-assisted cataract surgery in eyes with a small pre-op pupil size.

For more detailed information please view the abstract from the Journal of Cataract & Refractive Surgery.