New surgical technique for in-the-bag intraocular lens implantation in infants with microspherophakia and congenital cataracts

A new technique is described that enables in-the-bag implantation of an intraocular lens (IOL) in infants with microspherophakia and congenital cataract. In this technique, partial amputation of both haptics of a 3-piece IOL allows its in-the-bag implantation in pediatric eyes with a crystalline lens with reduced equatorial diameter. In the reported case, a 6-month-old baby with bilateral microspherophakia (equatorial lens diameter of 6.5 mm in both eyes) underwent surgery for congenital cataracts. There was no phacoiridodonesis before the procedure. After phacoaspiration, posterior capsulotomy, and anterior vitrectomy, a 3-piece IOL with both haptics partially amputated was implanted in the bag. During the 2-year follow-up, the IOL remained centered and without pseudophacodonesis. Vision improved from light perception to within the normal range for her age. There were no signs of glaucoma development.