title: Stabilizing the capsular bag and expanding the pupil with a pupil expansion device.
abstract: We describe a surgical technique for management of zonular instability and pupillary miosis using a pupil expansion device (Malyugin ring) in patients who need cataract surgery. In this technique, the pupil expansion device is first used in the usual fashion. After a capsulorhexis has been created, lateral scrolls of the pupil expansion device are released and repositioned to entrap both the anterior capsulorhexis and the pupil margin at the against-the-wound meridian (3 o'clock and 9 o'clock position) to fixate the unstable capsular bag to the iris. Phacoemulsification is performed, and the ring is removed after intraocular lens implantation. With this method, capsular stabilization and pupil expansion are achieved simultaneously with the same instrument.
  
  
  BACKGROUND
  No author has a financial or proprietary interest in any material or method mentioned.
authors.affiliation: From the Cornea Research Center, Mashhad University of Medical Sciences, Mashhad, Iran. Electronic address: zareis@mums.ac.ir.
authors.forename: Siamak
authors.initials: S
authors.lastname: Zarei-Ghanavati
authors.affiliation: From the Cornea Research Center, Mashhad University of Medical Sciences, Mashhad, Iran.
authors.forename: Homa
authors.initials: H
authors.lastname: Bagherian
mesh_terms: D019923:Capsulorhexis / Q000295:instrumentation*; D006801:Humans; D007431:Intraoperative Complications / Q000517:prevention & control; D007903:Lens Capsule, Crystalline / Q000601:surgery*; D019654:Lens Implantation, Intraocular; D008022:Ligaments / Q000502:physiology; D015877:Miosis / Q000503:physiopathology / Q000601:surgery*; D018918:Phacoemulsification / Q000379:methods*; D019736:Prostheses and Implants; D011680:Pupil / Q000502:physiology