title: Adjunct devices for managing challenging cases in cataract surgery: pupil expansion and stabilization of the capsular bag.
abstract: OBJECTIVE
  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.
  
  
  RESULTS
  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.
  
  
  CONCLUSIONS
  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.
authors.affiliation: Bascom Palmer Eye Institute, Miami, Florida 33136, USA.
authors.forename: James M
authors.initials: JM
authors.lastname: Goldman
authors.forename: Carol L
authors.initials: CL
authors.lastname: Karp
mesh_terms: D000818:Animals; D002387:Cataract Extraction / Q000295:instrumentation*; D004867:Equipment Design; D006801:Humans; D007498:Iris / Q000601:surgery*; D007903:Lens Capsule, Crystalline / Q000601:surgery*; D011680:Pupil; D013536:Suture Techniques / Q000295:instrumentation*