New gadgets for paediatric cataract surgery
Ken K Nischal MD
Paediatric cataract surgery presents special challenges that can be addressed with the right technology, Ken K Nischal MD, FAAP, FRCOphth, told AAO 2019 Paediatric Ophthalmology Subspecialty Day in San Francisco, USA.
While challenging to implant, the bag-in-lens designed by Marie-Jose Tassignon MD, PhD, effectively prevents PCO that can proliferate rapidly in young patients by encarcerating both the posterior and anterior capsule edges in its peripheral groove. Dr Nischal has seen cases go seven years and counting with no PCO using the bag-in-lens.
Femtosecond laser capsulotomy can be difficult in children’s eyes because the suction devices are too large, Dr Nischal said. He recommended a precision pulse capsulotomy device that creates a round, well-centred anterior capsulotomy using electrical pulses through a nitinol loop resting on the capsule.
Intraoperative OCT can be very helpful in cases with fibrosis, intumescent cataracts and posterior ruptures, allowing surgeons to see precisely where they need to cut to separate entangled tissues and avoid complications, Dr Nischal said. OCT is also excellent for planning surgery and teaching.
“They’re not just toys for boys or pearls for girls. Groovy gadgets can be used to improve outcomes,” said Dr Nischal, of the University of Pittsburgh, Pennsylvania, USA.