Bean-shaped rings offer capsular support where none exists
Bean-shaped rings can be useful devices for implantation of “bag-in-the-lens in eyes with loose or no capsular support,” said Marie José B. Tassignon, MD, PhD.
San Diego-Bean-shaped rings can be useful devices for implantation of “bag-in-the-lens in eyes with loose or no capsular support,” said Marie José B. Tassignon, MD, PhD.
As she explained, the only “absolute contraindication” of the bag-in-the-lens technique she developed is where there is no capsular support in which to implant the lens, or where support is deemed insufficient for lens success, said Dr. Tassignon, Belgium, during the 2015 meeting of the American Society of Cataract and Refractive Surgery.
“With previous bag-in-the-lens implantations, I always used a lasso technique in the past,” she said, but noted potential risks included resorption of the thread over time.
The lens itself has a 5-mm central optic with elliptical flanged haptics on the anterior and posterior surfaces with the haptics oriented 90° to each other. However, the centration and rotational stability over time is heavily dependent upon capsule integrity.
To that end, Dr. Tassignon developed polymethyl methacrylate bean-shaped ring segments designed so that when the IOL is placed, the inner semicircle of the bean segment slot into the interhaptic groove of the bag-in-the-lens, providing additional support to the IOL, she said.
“When you’re positioning within the capsular bag, calculate the white-to-white, minus 1mm,” she said. “At one part, you’ll have the bean-shaped ring and the IOL.” A second bean-shaped ring can be used on the other side of the bag to center the lens even more.
“If you need a second one, calculate the white-to-white and add 1 mm,” she said.
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