Beehler Pupil Dilator

Fortunately for all of us and also for our patients, these advances have undergone many refinements. Built into the pursuit of excellence in ophthalmic surgery is a wonderful ongoing, continuous quality improvement system. This process is impacted both through ongoing contributions we make as surgeons as well as those dedicated companies in the ophthalmic industry that support our endeavors.

Another setting in which a good capsulorrhexis is challenging is in patients with a poor red reflex such as hypermature lenses, very dense nuclear or dense PSC cataracts. In these cases, trypan blue is like a bridge over troubled water. It enables excellent visualization of the rhexis. Here, the caveat is that in hypermature cases we are often still dealing with a tense capsule, so great care must be taken to keep the rhexis from suddenly extending outward to the equator. Use of proper viscoelastics help minimize this concern.

A great case is built upon a series of great basic steps, one of which is a round, appropriately sized capsulorrhexis. This is a challenge in patients with small or scarred-down, irregular pupils. An easy "fix" in these patients can be achieved with the Beehler Pupil Dilator. (10-083 or 10-091)

It is important to rotate the instrument 90° when inserting and removing it from the anterior chamber. To maximize the effectiveness of the Beehler stretch, keep the instrument completely extended for a count of 30 before retracting the finger-like dilators and removing it from the eye. I then typically use Viscoat (Alcon, Fort Worth, Texas ) to maintain the dilation during the capsulorrhexis, which is now easy to perform. What I love about this instrument is that it is easy to use and virtually always gives me a 6-mm pupil. In addition, the postop appearance of the pupil is virtually always round and not excessively dilated.