Secondary Intraocular Lens Implant with Soemmering Ring Debulking

Current standard of care generally dictates that unilateral pediatric cataracts be removed by 6 weeks old and bilateral cataracts by 10 weeks old. There are numerous intricacies that arise when implanting an intraocular lens in a pediatric patient, including lens power, age of appropriate implantation, and the anatomical location of the IOL. Ideally, young children are left aphakic and placed in aphakic contact lenses or spectacles. Once the patient is old enough, or no longer tolerates aphakic correction, secondary IOL placement becomes important in order to mitigate the risk of amblyopia. Many surgeons will decide to place a secondary IOL in the sulcus or anterior chamber if enough fibrosis of the capsule has taken place since the original cataract extraction. However, the preferred position in both children and adults is placement of the IOL within the capsular bag. In order to do this, a dense Soemmering ring can be debulked, the anterior and posterior leaflets separated, and the lens placed within the newly opened bag.