Another anonymous USA resident sent me a video of the last case of residency, case number 250 where the nucleus is of average density, the pupil dilation is about 5mm, and the patient is receiving a toric IOL. Just looking at the picture above, we can see that the eye is in primary, the iris is parallel to the floor, and the draping is excellent. That is already a great start. Given this pupil size, would you be inclined to use a pupil expansion ring? I would not, but then again, I have a lot more experience than this young surgeon. If the pupil ring will give you more control of the case, a higher margin of safety in your hands, and less worries, then certainly, go for it and insert it. Overall, the case is excellent and this young surgeon will certainly go on to become quite an accomplished and well-respected surgeon. I would love to see case 1000 from this same surgeon in the future. If you are a new resident who is just beginning, watch the video and keep this as a benchmark of something that you can achieve.
