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Jacey Hanna, Neil Kalbag, Albert S Khouri; Visual outcomes after uncomplicated complex cataract surgery: Malyugin ring versus iris hooks. Invest. Ophthalmol. Vis. Sci. 2014;55(13):2812.
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© ARVO (1962-2015); The Authors (2016-present)
To compare the outcomes of visual recovery of uncomplicated complex cataract surgery performed using Malyugin ring or iris hooks.
Records of patients undergoing complex cataract surgery requiring use of pupil expansion devices (Malyugin ring and iris hooks) with no intraoperative complications (capsular rupture, subluxation of lens fragments, and need for anterior vitrectomy) who presented over a 5 year period to the New Jersey Medical School were reviewed. Data of visual acuity (VA), intraocular pressure, and pseudophakic macular edema (PME) up to 18 months post-operatively was collected (baseline, 1d, 1week, 1m, 3m, 6m, 12m, 18m). To analyze speed of visual recovery, logMAR of the best corrected vision was compared to visual acuity at several time points in the postoperative period.
A total of 40 eyes (20 undergoing use of Malyugin ring and 20 iris hooks) were included. Mean LogMAR VA at baseline compared to all time points is summarized in table 1. VA improved from baseline in the Malyugin ring group at all time points except at 18 months (p<0.05). In the iris hooks group, VA worsened initially at 1 week and 1month, then improved from baseline starting at the 1 month time point, although results were not statistically significant (p>0.05). Patients in the Malyugin ring group seemed to achieve visual recovery at a faster rate than patients undergoing use of iris hooks (the mean LogMAR difference to best corrected vision at postoperative day and week 1 were 0.20, 0.23 in the Malyugin group vs 0.58, 0.48 in the iris hooks, p<0.05). Visual recovery was similar at other time points. IOP at baseline and all time points was similar in both groups. PME was noted in 3 patients in the Malyugin ring versus none in the iris hooks group.
Visual acuity improved after uncomplicated complex cataract surgery requiring pupil management. In this cohort, patients undergoing use of Malyugin ring achieved faster initial visual recovery but both groups were similar at 1 month and beyond.
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