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Subspecialties Cataract, Practice Management, Professional Development

Simplifying Complexity

At a Glance

  • The Malyugin Ring was designed by Boris Malyugin to address the problems associated with existing pupil expanders
  • Manufactured from 5-0 polypropylene, the Malyugin Ring 2.0 is ideal for difficult-to-dilate pupils as it offers enhanced visualization of the anterior chamber
  • The ring is inserted through a main corneal incision, reducing surgical trauma and minimizing the risk of contamination and postoperative inflammation
  • Used correctly, the Malyugin Ring 2.0 can be beneficial to your practice and significantly speed up the cataract surgery process.

Good visualization of the lens is essential for safe, effective cataract surgery. This is best achieved when pupils are dilated to an adequate level during the procedure. But what happens when they are not? Inadequate pupil dilation can lead to surgical complications that all ophthalmic surgeons wants to avoid – iris damage, bleeding, prolapse, intraoperative floppy iris syndrome (IFIS), anterior capsule trauma and possible misalignment of the IOL. So what are the current approaches to small pupil management in complex cataract cases? Options include cutting the iris at the edge, stretching the pupil with two side instruments, heavy viscoelastic, use of iris hooks, medical dilation or using pupil expansion devices, such as Malyugin Ring 2.0. The Malyugin Ring was designed by Boris Malyugin (Professor of Ophthalmology, Deputy Director General at the S. Fyodorov Eye Microsurgery State Institution, Moscow, Russia) to address the problems associated with some pupil expanders, such as potential overstretching of the iris sphincter or extended surgery time (1). Developed to enhance cataract surgery in complicated small-pupil cases, the Malyugin Ring 2.0 is a safe and accurate device – and one that I like to use in both standard and complex cataract cases.

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About the Author

Danson V. Muttuvelu

Consultant and Ophthalmic Surgeon at Aalborg University Hospital, Denmark

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