Novel technique described for pars plicata manual PCCC in children

The authors describe a technique for performing manual posterior continuous curvilinear capsulorhexis (PCCC) through the pars plicata after implantation of an IOL in the capsular bag during pediatric cataract surgery. The technique can be used selectively to create a posterior capsulectomy of a desirable size in a controlled manner to avoid destabilization of the IOL.

The authors say that it is mandatory to perform a small PCCC in small eyes to avoid vitreous prolapse and destabilization of the IOL. A manual PCCC creates an opening with a strong margin that resists peripheral tears and holds the vitreous in place, they say. It allows safe anterior vitrectomy and prevents uncontrolled widening of the opening. IOL centration and stability are not disturbed during the posterior capsulectomy, and in-the-bag fixation of the IOL can be achieved more consistently. A posterior capsule opening of the desired size is achieved since the IOL is in place.

Although performing manual posterior capsulorhexis is technically challenging, the authors say it remains a gold standard because it offers greater resistance to capsule tearing and yields a smooth round edge.