Small Pupil Management
Objectives
- Demonstrate ability to insert and remove a Malyugin ring
- Discuss when iris hooks would be appropriate during cataract surgery and how to place them.
Reading
- Henderson BA. Essentials of Cataract Surgery, second edition. Thorofare, NJ: Slack Inc., 2014. (WW 260 E78 2014). isbn 978-1-61711-0672
- Chapter 22, Small Pupil, pages 235-248
(UIHC Link) - Kim, Terry. Curbside Consultation in Cataract Surgery: 49 Clinical Questions, second edition. Thorofare, NJ: Slack Inc., 2014
- Question 20: What is the Best Way to Manage Intraopertive Floppy Iris Syndrome?
- Question 21: My patient has a Small Pupil. What are my Options for Expansion?
Videos
• Malyugin Rings
Malyugin ring insertion and removal
Watch on YouTube
Nice malyugin ring insertion and removal
Watch on YouTube
Malyugin ring tips
Watch on YouTube
Malyugin ring our first time
Watch on YouTube
Nice placement of malyugin ring
Watch on YouTube
Malformed malring
Watch on YouTube
Malyugin ring issues
Watch on YouTube
Ring removal Cinci style
Watch on YouTube
Late placement of malyugin ring
Watch on YouTube
Cohen easy pull technique
Watch on YouTube
A hook and a ring
Watch on YouTube
• Iris Hooks
Iris hooks (Placing Hooks)
Watch on YouTube
IFIS with hooks
Watch on YouTube
Iris hooks in a diamond configuration
Watch on YouTube
So many paracenteses
Watch on YouTube
Simulation
EYE MODEL
- Phillips Malyugin PS-033
- Kitaro Complex Lab Small pupil (requires small pupil cornea-iris, K-6030)
- SimulEYE Small Pupil
EQUIPMENT
Malyugin ring
Iris hooks
Sideport blade
keratome
Angled tying forceps
Kuglen hook
Malyugin ring
Iris hooks
Sideport blade
keratome
Angled tying forceps
Kuglen hook
Videos for simulation
Suggested citation format: Haugsdal J, Kitzmann A, Oetting TA. The Iowa Ophthalmology Wet Laboratory. EyeRounds.org. Updated Posting June 28, 2021. Originally Posted December 6, 2012. Available from http://www.EyeRounds.org/tutorials/Iowa-OWL-o2021/
