Buonsanti Dual Hooks, A Novel Device For Iris And Capsule Support

Zonulopathy is a problem that often presents together with a small pupil size.

It's expected for 10% of patients with pseudoexfoliation syndrome to have zonular weakness.

Sometimes it can only be addressed during capsulorhexis, and specially if the patient has a small pupil as not much can be seen.

Altough we already have them individually, using both will involve many incisions. Intraocular devices to expand the pupil can damage the endothelium and really hard to use together with capsular hooks.

In patients who needed only pupil expansion we used the iris retractors, in those who needed capsule support the capsule hooks were used, and those who needed both were adressed with iris retractors+capsule hooks.

The pupil size achieved was safe for performing surgery, similar to classical iris hooks.

The zonular support was also as efficient as with capsular hooks.

Hooks were introduced together and also one at a time to see which was the easiest and faster way.

The need of less sideport incisions, being safe for endothelium and reusable are all charasteristics that make them more affordable.

More cases are needed to find out the easier way of using them. 

Its a new option and tool for our armamentarium as surgeons in difficult cases.