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Case Reports
. 2020 Jun;68(6):1188-1191.
doi: 10.4103/ijo.IJO_1675_19.

B-HEX pupil expander in vitreoretinal surgery - A case series

Debdulal Chakraborty  1 , Ayan Mohanta  1 , Arup Bhaumik  1
Affiliations
Case Reports

B-HEX pupil expander in vitreoretinal surgery - A case series

Debdulal Chakraborty et al. Indian J Ophthalmol. 2020 Jun.

Abstract

We describe the successful use of the B-HEX pupil expansion device in four cases of combined phacovitrectomy with significant cataract, non-dilating pupil, and surgical vitreoretinal pathologies including vitreous hemorrhage, inferior retinal detachment (RD) with proliferative vitreoretinopathy in an oil filled eye, recurrent rhegmatogenous RD, and macular hole with RD localized to the posterior pole in an eye with uveitic sequelae. The B-HEX remained well engaged and maintained excellent mydriasis throughout the surgery despite wide fluctuations in intraocular pressure and anterior chamber fluidics. This is the first series describing use of B-HEX for combined phacovitrectomy due to myriad causes.

Keywords: B-HEX; phacovitrectomy; pupil expander; vitreoretinal surgery.

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Conflict of interest statement

None

Figures

Figure 1
Figure 1
(a) Dense cataract with small pupil before cataract surgery. (b) B-HEX placed in situ after capsulorhexis. (c) Branch retinal vein occlusion with coexistent retinal tear treated with sectoral laser photocoagulation and barrage laser, respectively. (d) Image showing a round and symmetrical pupil at the end of surgery
Figure 2
Figure 2
(a) Non-dilating pupil due to long-term tamsulosin therapy for prostatic hypertrophy. (b) Ultra widefield retinal image showing inferior retinal detachment with PVR membranes. (c) Intraoperative image showing PVR membranes being dissected in the extreme inferior periphery via the expanded pupil. (d) An attached retina with silicone oil tamponade (Postoperative ultra widefield image)
Figure 3
Figure 3
(a) Small rigid pupil with mature cataract. (b) Ultrasound Bscan image showing the retinal detachment. (c) Shallow retinal detachment seen intraoperatively. (d) Silicone oil filled eye
Figure 4
Figure 4
(a) Anterior segment image showing posterior synechiae, complicated cataract, and poor mydriasis. (b) Wide dilatation provided by the B-HEX. (c) Retinal detachment localized to the posterior pole and associated with macular hole and preretinal membrane secondary to resolved uveitis. (d) B-HEX being taken out by the 0.9 mm side port
See this image and copyright information in PMC

References

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