Expandable glide occludes pupil

A novel expanding lens glide holds promise to provide a useful addition to the cataract surgeon's armamentarium of techniques for managing cases involving a posterior capsule tear.

Boston-A novel expanding lens glide holds promise to provide a useful addition to the cataract surgeon's armamentarium of techniques for managing cases involving a posterior capsule tear, said Anita Nevyas-Wallace, MD, at the annual meeting of the American Society of Cataract and Refractive Surgery.

The device is being developed by Varitronics Inc. and still is in the prototype stage.

"The development of a capsular tear during phacoemulsification surgery presents a challenge because, while cataract surgery incisions have gotten smaller, posterior capsular tears are as large as ever," Dr. Nevyas-Wallace said.

How it works

The expanding glide is constructed of the same thin polyethylene material as a standard Sheets lens glide, but has a curved three-leaf configuration. The three leaves are held together by a tiny rivet that allows them to be swiveled easily, opening like a fan. When the handle tabs are brought together in the front, the glide is in the contracted position. To expand it, the surgeon simply brings the handle tabs together in the back.

The procedure for using the glide in the setting of a posterior capsular tear with retained nuclear fragments would be first to elevate the fragments into the anterior chamber by injecting viscoelastic. Next, the glide is inserted through the phaco incision, and once it is maneuvered under the nuclear fragments, the back handle tabs are pushed together so that the leaves separate and the glide expands to be a much wider spatula, providing greater protection against the pieces of nucleus falling posteriorly through the capsular opening.

Once removal of the nuclear fragments is accomplished, either through another incision or through an enlarged main incision, the glide elements are contracted and the device is removed.