To stretch a small pupil, you actually don’t need special instruments. Using two instruments such as choppers, hooks, or manipulators, the iris can be held and stretched quite effectively. In the case shown here, we use just our standard chopper in the left hand and the capsulorhexis forceps in the right. The forceps are used to gently grasp the iris stroma at the pupil margin and the stretch is completed. How does this compare to using a pupil expansion ring instead?
The results are actually very similar. For this patient, we have a contralateral eye study since his right eye had a Malyugin ring for cataract surgery and his left eye had the pupil stretching shown in the video below. At the end of the case, the structural and anatomic result of the pupil is essentially the same.
It’s the surgeon’s choice:
to enlarge a small pupil, use the method that works best in your hands
Click below to learn from this video of pupil stretching using capsulorhexis forceps:
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