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  • Back Pars Plana Posterior Capsulectomy and Anterior Vitrectomy
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    Vitrectorhexis and IOL Implantation

    By M. Edward Wilson, MD
    Cataract/Anterior Segment, Pediatric Ophth/Strabismus

    Dr. M. Edward Wilson demonstrates the use of a virectorhexis to create the opening in the anterior capsule in a case of infantile cataract. While a manual capsulorhexis is typically used in pediatric cataract patients more than a year old, in very young infants, a vitrector provides improved control and a smooth rhexis. With the vitrector cutting port face-down, Dr. Wilson uses a bimanual technique and 20-gauge instruments to shape the rhexis and then irrigate and aspirate the cortical remnants. Once the cortex is cleaned completely, a clear corneal incision is made, a viscoelastic is injected, and a 1-piece acrylic lens is placed in the bag. In such cases, Dr. Wilson prefers to shape the posterior capsule once the IOL is seated and oriented properly.