A new horseshoe-shaped silicone device (Clarke Horseshoe, ReaLens LLC) for pupil enlargement and iris stabilization in cases of intraoperative floppy iris syndrome (IFIS) should soon be on the market.
The device, which is injected through a 2.4-mm incision, unfolds to naturally and gently enlarge the pupil and intraoperatively prevent iris prolapse, said Gerald P. Clarke, MD, Optivision Eyecare, Oshkosh, WI, who developed the product.
The dilator has a 2-mm rim that fits around the iris to hold it in the eye during surgery. It is inserted with a special injector that Dr. Clarke developed, which provides greater control during the insertion process than injecting it in a similar fashion to an IOL.
For removal, a small hook is inserted into one of the positioning eyelets in the device so that it can easily be slid out.
The horseshoe dilator may be an alternative to the Malyugin ring (MicroSurgical Technology) in some cases of IFIS, Dr. Clarke suggested. He explained that Malyugin rings and similar pupil expansion devices can cause the iris to stretch during insertion or removal, causing microtears in the sphincter and leaving the pupil slightly dilated.