Dr. David Plager demonstrates the ideal situation for secondary in-the-bag IOL placement following congenital cataract surgery. As in most cases of previous pediatric cataract surgery, a Sommering ring has developed. The ring keeps the anterior and posterior leaflets separated from one another, maintaining a peripheral capsular bag. Taking care to keep this ring intact for stability, the surgeon reopens the capsular bag, performs an anterior vitrectomy, and aspirates all material. An OVD is injected between the leaflets of anterior posterior capsule to create space for an IOL. A 3-piece acrylic IOL is finally folded and dialed into the bag.