2020–2021 BCSC Basic and Clinical Science Course™
11 Lens and Cataract
Chapter 12: Preparing for Cataract Surgery in Special Situations
Altered Lens and Zonular Anatomy
Cataract in Aniridia
The lens capsule in patients with aniridia is thin and fragile, which makes performing a capsulorrhexis more challenging. Ideally, the edge of a well-centered capsulorrhexis overlaps the optic edge by 1 mm. Corneal haze and neovascularization are common in these eyes because of stem cell deficiency; capsular staining may aid visualization through the cornea during creation of an adequately sized capsular opening. Use of a high-viscosity OVD also optimizes visualization while stabilizing the capsular surface. The surgeon should avoid working inside the capsular bag, which could place tension on the capsular rim. Low infusion helps reduce turbulence and capsular fluctuation. The capsule in aniridic eyes acts as a pseudoiris when it opacifies.
Excerpted from BCSC 2020-2021 series: Section 11 - Lens and Cataract. For more information and to purchase the entire series, please visit https://www.aao.org/bcsc.