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Removal of tissue bridges between posterior capsule, anterior hyaloid needed in pediatric bag-in-the-lens implantation
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BERLIN — Bag-in-the-lens implantation is a suitable technique for congenital cataract, but special care must be taken to remove the proliferative tissue bridges between the posterior capsule and anterior hyaloid, according to Marie-José Tassignon, MD.
"I use a caliper ring to perform a 4.5-mm capsulorrhexis. Thanks to the caliper, I can avoid using staining that would affect the rigidity of the capsular bag. In these soft anterior capsules, it is also important to perform the capsulorrhexis tear vertically rather than horizontally," she said at the World Ophthalmology Congress here.
When the posterior capsulorrhexis is performed, a thorough, gradual removal of the tissue bridges between the posterior capsule and anterior hyaloid is performed.
"Adhesion can be quite strong and might require a bimanual technique. Progress slowly, and while you free the capsule, perform your posterior capsulorrhexis one step at a time. Keep going until you have completely released the vitreous," Dr. Tassignon said.
"If any of these tissue bridges are left in place, traction might cause the posterior capsule edge to come out of the [bag-in-the-lens] groove," she noted.
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