Reopening the severely contracted lens capsular bag post phaco-vitrectomy by mini anterior peripheral capsulorhexis and visco-dissection

Abstract

To introduce a novel technique for reopening the capsular bag with severe fibrosis for aphakic patients after primary phaco-vitrectomy. Ocular viscosurgical device (OVD) was injected into the anterior chamber. An area of the anterior capsule was identified where the fibrosis was less severe and therefore left a wider healthy peripheral capsule. A cystitome was used to perforate the anterior capsule near the anterior capsular margin, and care was taken not to injure the posterior capsule below. The mini anterior capsulorhexis was then performed with capsular forceps, approximately 2 mm in diameter. A blunt cannula was used to slightly separate the anterior and posterior capsule right at the mini capsulorhexis. OVD was then injected slowly and continuously through the mini-opening to separate the two layers until the capsular bag was completely reopened. A foldable IOL was implanted into the capsular bag. Four consecutive cases (4 eyes) were enrolled in this study. All the fibrotic capsular bags in four eyes were reopened by mini anterior peripheral capsulorhexis combined with visco-dissection. Secondary in-the-bag IOL implantation was carried out smoothly. Conclusion: This novel surgical technique is safe and effective in reopening the capsular bag with severe fibrosis after primary phaco-vitrectomy.