Advanced Cases of Bag-in-the-Lens Implantation Using Bean-Shaped Rings in or out of the Capsular Bag
Purpose
The only absolute contraindication of the bag-in-the-lens technique where there is no or insufficient capsular support in which to implant the lens. To overcome this drawback bean shaped rings have been developed with capsular, ciliary or scleral fixation.
Methods
Five patients with weak zonules needing primary cataract surgery or secondary IOL implantation were prospectively selected for bag-in-the-lens implantation with the help of bean shaped rings. These devices were specifically designed to support the bag-in-the-lens taking into consideration that the smallest curvature should be inserted into the lens groove while the largest curvature could be positioned in the capsular bag, in the ciliary sulcus or sutured to the sclera.
Results
It was possible to implant the bag-in-the-lens in all five cases provided the bean shaped rings were used to help for a save and stable IOL positioning. In one eye both beans were implanted in the capsular bag, in two eyes one bean was implanted in the capsular bag and the other was implanted in the sulcus. In one eye both beans were implanted in the ciliary sulcus and in one eye the beans were sutured to the sclera. This eye was the only eye without presence of any capsular support.
Conclusion
The bean shaped rings are useful devices to help for implantation of bag-in-the-lens in eyes with loose or no capsular support.