What factors are likely to affect buying decisions? Cost is a consid-
eration, of course. Some rings are disposable, while some may be
used up to 5 times. Some come attached to inserters, some require
separate injectors that need to be sterilized between uses. Some are
square, some provide a more circular space. For Dr. Newsom, the
most important consideration is how easy it is to get the ring into the
eye and back out again.
"Surgeons have different techniques, different likes and dislikes," he
says. "The big thing is to try several different ones. The one that
works best is the one that fits with your technique."
Some options to consider:
• Malyugin Ring 2.0 (MicroSurgical Technology). The popular ring
has 8 points of fixation, with a goal of ensuring a round pupil (6.25
mm and 7 mm sizes are available), and reducing the risk of damage to
the iris. Last year, the company released an updated version that's
softer and more elastic, and can be inserted through smaller (1.8 to 2
mm) incisions. The smaller size is also intended to address inadequate
pupil size during femtosecond laser cataract surgery. Like its prede-
cessor, the ring looks like a baseball diamond with a loop at each cor-
ner. It's disposable and comes
with newly designed disposable
injectors that are easier to
engage and disengage. The
Osher Malyugin Ring
Manipulator is reusable, howev-
er.
"I've become so comfortable
putting it in and getting it out,
and it is very stable," says Aaron
Petersen, MD, of the
A P R I L 2 0 1 7 • O U T PA T I E N TS U R G E R Y. N E T • 1 0 5
• The updated Malyugin Ring is softer and can be inserted
through smaller incisions.