AAO 2019 Video Program
    Pediatric Ophth/Strabismus

    Microspherophakia is associated with abnormally lax zonules and elastic capsule, which pose a great challenge while creating capsular openings. In our technique, two 23-gauge MVR blades are introduced simultaneously into the capsular bag, ~180° apart at equator/ just posterior to it. Simultaneous use of two MVR blades helps to bring subluxated/dislocated lens into the visual axis. Further, one MVR stabilizes the unstable lens and also provides countertraction for the opposite MVR, thus creating capsular openings in a more controlled manner. Juxtaequatorial is the relatively thicker and stronger part of the capsule, hence minimizing risk of premature extension and also enabling good visibility of intraoperative maneuvers through undisturbed anterior capsule. This technique was performed in eight eyes of four microspherophakia patients with a mean age of 7.25 ± 2.2 years. Endocapsular lens aspiration was successfully performed in all patients without any intraoperative difficulties. At 3 months postoperatively, BCVA of 0.12 ± 0.11 was achieved.