advantages they pro-
vide.
"The devices save
surgeons time, and
lower the risk of vitre-
ous loss and iris pro-
lapse," says Jon-Marc
Weston, MD, a sur-
geon at NVision Eye
Center in Aliso Viejo,
Calif. "Surgeons must
put a device in as
soon as they think
they need it in order to maintain pupil retention during the case."
Dr. Weston can insert and remove his ring of choice in 1 to 2 min-
utes, a fraction of the 5 minutes he'd spend struggling to operate
through a floppy iris. Saving close to 4 minutes of operative time is no
small benefit in a volume-driven specialty.
He says reusable iris hooks are an inexpensive option, but surgeon
preference may prevent their use. Plus, he adds, hooks can be harder
to place than rings, a factor that extends OR time, which actually
increases case costs.
"Expansion rings can be less time-consuming to use and, if avail-
able, a reusable device can be cost effective if surgeons and repro-
cessing techs can manage it gently," says Dr. Weston.
Dilating drugs
Patients with established miosis require the use of a pupil expanding
device. Patients with possible miosis, whose pupils dilate to 5 mm to 6
mm, are candidates for Omidria, an intraocular irrigating solution con-
1 0 4 • O U T PA T I E N T S U R G E R Y M A G A Z I N E • O C T O B E R 2 0 1 9
• HARD COSTS Pupil expansion devices give surgeons the access they need during
difficult cases.
Pamela
Bevelhymer,
RN,
BSN,
CNOR