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Capsular peeling proves effective in treating IOL misalignment
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 Marie Jose Tassignon |
ORLANDO, Fla. — Capsular peeling is a suitable treatment for IOL misalignment resulting from postoperative changes in the capsular bag related to healing, a surgeon said here.
Marie Jose Tassignon, MD, shared pearls about the technique during Refractive Subspecialty Day preceding the American Academy of Ophthalmology meeting.
In the case of a patient who received a posterior chamber multifocal IOL and later complained of visual symptoms, Dr. Tassignon said, "She was happy immediately after surgery, but after a couple of weeks she wasn't happy anymore." In this case, the lens was decentered and the nuclear capsulorrhexis was not well centered.
The following are Dr. Tassignon's observations about the procedure:
-- The procedure is particularly difficult because of the potential for capsular perforation and decentration of the capsulorrhexis.
-- It is important to use a bilateral technique to avoid rupturing the zonular fibers while removing perforated capsule material. The bimanual technique helps maintain the capsular bag by minimizing tension on the zonular fibers.
-- Peeling is relatively easy to perform under certain silicone lenses but more difficult under hydrophobic or hydrophilic lenses.
-- The 12-o'clock surgical position is the most difficult orientation.
-- An "impressive" amount of tissue may form in the damaged capsule, even 4 to 6 months after surgery.
-- The peeling technique may obviate the need to perform lens explantation.
- Disclosure: Dr. Tassignon has a financial relationship with Morcher GmbH..