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

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.