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Application of an iris speculum for removing Soemmerring ring during secondary intraocular lens implantation in congenital cataract patients with small pupils.

An application of the XpandNT iris speculum in eyes with small pupils during secondary intraocular lens (IOL) implantation in congenital cataract patients is described. The iris speculum was first positioned in the eye to expand the pupil. A 30-gauge needle was used to separate the adhesion of the iris tissue and the capsular rim. Vitrectomy was used to clean Soemmerring ring near the capsular rim. The iris expander was retracted with the Williamson XpanNT Manipulator. The IOL was then implanted. Fourteen aphakic eyes from 10 consecutive patients were studied retrospectively; pupil expansion was achieved in all 14 eyes intraoperatively without serious intraoperative or postoperative complications. The XpandNT iris speculum was a safe and excellent tool for removing Soemmerring ring and solving small pupil problems during secondary IOL implantation in pediatric cataract surgery patients.