Adjunct devices for managing challenging cases in cataract surgery: Pupil expansion and stabilization of the capsular bag

James M. Goldman, Carol L. Karp

Research output: Contribution to journalReview article

25 Scopus citations


PURPOSE OF REVIEW: Patients anticipate favorable surgical outcomes when having cataract surgery. The modern-day cataract surgeon should employ all necessary means to achieve this result. A working knowledge of adjunct devices for pupil expansion and capsular-bag stabilization can significantly improve surgical outcomes. RECENT FINDINGS: Adjunct devices for pupil expansion include the Beehler pupil dilator, nylon iris hooks, and pupillary rings, including the Perfect Pupil, the Graether 2000, and the Morcher pupil dilator. Capsular-bag stabilization can be accomplished with capsular tension rings, capsular tension segments or iris hooks. The recent literature on these devices is reviewed. SUMMARY: Impaired visualization through a small pupil and poor tissue stabilization increases the chance of tissue damage, retained nuclear material, and vitreous loss. Fortunately, inadequate mydriasis and instability of the capsular bag can be managed safely with the use of adjunct tools. Preoperative planning, familiarity with available tools, and accessibility of these devices in the operative setting is necessary.

Original languageEnglish (US)
Pages (from-to)44-51
Number of pages8
JournalCurrent opinion in ophthalmology
Issue number1
StatePublished - Feb 1 2007



  • Capsular tension rings
  • Capsular tension segments
  • Capsular-bag stabilization
  • Cataract devices
  • Iris hooks
  • Small pupil

ASJC Scopus subject areas

  • Ophthalmology

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