- Email: [email protected]
Iris Retractor Mounted Laterally on Anterior Chamber Irrigator
NOTES, CASES, INSTRUMENTS IRIS RETRACTOR MOUNTED LATERALLY ON A N T E R I O R CHAMBER IRRIGATOR DAVID S. Dow,
M.D.
Waco, Texas
An irrigator tip modified to facilitate re traction of the iris during cataract extraction with cryotherapy instruments was devised by attaching a curved, smooth-tipped iris re tractor to the side of a standard Bishop-Har mon irrigator tip* (Fig. 1). In round-pupil extractions, this provides the surgeon with an iris retractor which is rolled out to disen gage it from the iris, similar to the Rosenbaum-Drews 1 iris retractor. At the same time, it provides immediate proximity of the irrigator tip for defrosting, as in the Harstein2 irrigator-retractor. Iris retractors such as the Harstein or Bronson-Turtz 3 provide excellent retraction of the iris, but have the disadvantage of stretching the iris upon twisting free from the sphincter margin, or requiring some ad vancement back toward the anterior chamber for disengagement if a torsional maneuver for release is undesirable. The irrigator-re tractor described herein combines the advan tage of rotation for disengagement with readily available defrosting ability without having to change instruments or have the as sistant provide defrosting. This is of partic ular value when the surgeon cannot operate with a fully-trained assistant, such as a resi dent or an experienced ophthalmologically oriented nurse. The design of this instrument evolved from my own practice of using an unmodified Bishop-Harmon irrigator tip for iris retraction for several years. However, I felt that having a specific iris retractor at tached to the irrigator tip would provide a
Fig. 1 (Dow). Iris retractor mounted laterally on anterior chamber irrigator (center), illustrated with Bronson-Turtz plastic iris retractor for cryosurgery (right), shown with millimeter scale.
more definitive means of retracting, as the iris was found occasionally to slip out from under the unmodified tip, or excessive pres sure onto the lens capsule was necessary to prevent slippage. The tip of the attached re tractor can also be utilized for direct zonular stripping if desired. SUMMARY
To facilitate retraction of the iris during cataract extraction a curved, smooth-tipped iris retractor is attached to the side of a standard Bishop-Harmon anterior chamber irrigator tip. The tip of the attached retrac tor may also be used for direct zonular strip ping if desired. REFERENCES
1. Rosenbaum, H., and Drews, R. : Iris retractor for cryo-extraction. Trans. Am. Acad. Ophth. Otolaryng. 71:369, 1967. 2. Harstein, J. : Combined irrigator and iris re tractor for cryosurgery. Am. J. Ophth. 63:990, 1967. 3. Bronson, N., and Turtz, A.: Cryosurgical iris retractor. Am. J. Ophth. 62:1S0,1966.
Reprint requests to David S. Dow, M.D., 2223 Austin Avenue, Waco, Texas, 76701. * Manufactured by Storz Instrument Company. 138
M.D.
Waco, Texas
An irrigator tip modified to facilitate re traction of the iris during cataract extraction with cryotherapy instruments was devised by attaching a curved, smooth-tipped iris re tractor to the side of a standard Bishop-Har mon irrigator tip* (Fig. 1). In round-pupil extractions, this provides the surgeon with an iris retractor which is rolled out to disen gage it from the iris, similar to the Rosenbaum-Drews 1 iris retractor. At the same time, it provides immediate proximity of the irrigator tip for defrosting, as in the Harstein2 irrigator-retractor. Iris retractors such as the Harstein or Bronson-Turtz 3 provide excellent retraction of the iris, but have the disadvantage of stretching the iris upon twisting free from the sphincter margin, or requiring some ad vancement back toward the anterior chamber for disengagement if a torsional maneuver for release is undesirable. The irrigator-re tractor described herein combines the advan tage of rotation for disengagement with readily available defrosting ability without having to change instruments or have the as sistant provide defrosting. This is of partic ular value when the surgeon cannot operate with a fully-trained assistant, such as a resi dent or an experienced ophthalmologically oriented nurse. The design of this instrument evolved from my own practice of using an unmodified Bishop-Harmon irrigator tip for iris retraction for several years. However, I felt that having a specific iris retractor at tached to the irrigator tip would provide a
Fig. 1 (Dow). Iris retractor mounted laterally on anterior chamber irrigator (center), illustrated with Bronson-Turtz plastic iris retractor for cryosurgery (right), shown with millimeter scale.
more definitive means of retracting, as the iris was found occasionally to slip out from under the unmodified tip, or excessive pres sure onto the lens capsule was necessary to prevent slippage. The tip of the attached re tractor can also be utilized for direct zonular stripping if desired. SUMMARY
To facilitate retraction of the iris during cataract extraction a curved, smooth-tipped iris retractor is attached to the side of a standard Bishop-Harmon anterior chamber irrigator tip. The tip of the attached retrac tor may also be used for direct zonular strip ping if desired. REFERENCES
1. Rosenbaum, H., and Drews, R. : Iris retractor for cryo-extraction. Trans. Am. Acad. Ophth. Otolaryng. 71:369, 1967. 2. Harstein, J. : Combined irrigator and iris re tractor for cryosurgery. Am. J. Ophth. 63:990, 1967. 3. Bronson, N., and Turtz, A.: Cryosurgical iris retractor. Am. J. Ophth. 62:1S0,1966.
Reprint requests to David S. Dow, M.D., 2223 Austin Avenue, Waco, Texas, 76701. * Manufactured by Storz Instrument Company. 138