Encyclopedia of Ophthalmology

Living Edition
| Editors: Ursula Schmidt-Erfurth, Thomas Kohnen

Pupil Dilator

Living reference work entry
DOI: https://doi.org/10.1007/978-3-642-35951-4_402-4


Device for pupil extension during ocular surgery.


The use of pupil dilators should be considered in cataract surgery with small nondilating pupils, iris prolapse, and intraoperative floppy iris syndrome.



Use and Dosage

Different devices are currently available for intraoperative pupil dilation. Iris hooks are applied for four to five point iris retraction. Iris hooks are placed in sideports 1 mm posterior of the corneoscleral junction. Alternatively, ring expanders may be used for pupil expansion. Ring expanders reduce the risk of iris-sphincter damage due to a circumferential expansion of the pupil. Different devices are available and should be used according to the surgeon’s preference.

Adverse Reactions

Excessive stretching of the pupil may result in iris sphincter damage. Improper positioning and removal of pupil dilators may result in tears of the anterior capsule or iridodialysis.


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Further Reading

  1. Cantrell MA, Bream-Rouwenhorst HR, Steffensmeier A, Hemerson P, Rogers M, Stamper B (2008) Intraoperative floppy iris syndrome associated with alpha1-adrenergic receptor antagonists. Ann Pharmacother 42(4):558–563, Epub 2008 Mar 25. ReviewCrossRefPubMedGoogle Scholar
  2. Goldman JM (2007) Karp. Adjunct devices for managing challenging cases in cataract surgery: pupil expansion and stabilization of the capsular bag. Curr Opin Ophthalmol 18(1):44–51, ReviewCrossRefPubMedGoogle Scholar

Copyright information

© Springer-Verlag Berlin Heidelberg 2016

Authors and Affiliations

  1. 1.Department of OphthalmologyUniversity of Regensburg Medical CenterRegensburgGermany
  2. 2.Department of OphthalmologyGoethe-Universität Frankfurt/MainFrankfurt/MainGermany