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Binkhorst Medal Lecture addresses posterior capsular opacification

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Marie-José Tassignon

VIENNA, Austria — A surgeon addressed the crucial issue of posterior capsular opacification after cataract surgery in the Binkhorst Medal Lecture at the opening ceremony of the European Society of Cataract and Refractive Surgeons meeting here.

"We have the treatment for PCO, but it's important to know that even after YAG capsulotomy, the quality of image is not entirely restored. This is because PCO not only affects capsule transparency, but also changes the position of the IOL in the eye," Marie-José Tassignon, MD, PhD, said during her lecture, entitled "To bag or not to bag."

Dr. Tassignon's bag-in-the-lens (BIL) is both an original IOL concept and an implantation technique aimed at preventing secondary cataract.

"The contact of lens epithelial cells with the lens optic is minimal. They are entrapped in the periphery, within a solid fibrotic plug formed by the merging of anterior and posterior capsule, and cannot migrate towards the center of the lens," Dr. Tassignon said.

A study of 807 eyes, many of which were subject to increased cell proliferation due to coexisting pathologies such as glaucoma or diabetes, showed that BIL maintained a perfectly clear visual axis.

Further developments of the BIL concept are a toric model, made possible by the stable IOL centration provided by the technique, and the bean-shape ring, an artificial capsule that allows the implantation of the lens in eyes without capsular support.

"In the future, we might be able to have a fixed, circular haptic support and a removable optic that could be changed according to the evolving needs of the patients," Dr. Tassignon said.

At present, however, BIL exchange is easy and predictable, making the choice of this IOL particularly suitable for pediatric patients.

• Disclosure: Dr. Tassignon has intellectual property rights to the bag-in-the-lens IOL, which is licensed to Morcher.