title: Modified technique for removal of Soemmerring ring and in-the-bag secondary intraocular lens placement in aphakic eyes.
abstract: We describe modifications to previously described techniques for evacuation of Soemmerring ring during secondary intraocular lens (IOL) implantation in aphakic eyes following previous pediatric cataract surgery. A new anterior capsulotomy is initiated using a cystotome to incise the anterior capsule close to its attachment to the posterior capsule. A curved microscissor is used to cut circumferentially, completing the capsulotomy, and a dispersive ophthalmic viscoelastic device (OVD) is used to viscoexpress Soemmerring ring material from the capsular bag. A 2-handed maneuver is used to manually divide the Soemmerring ring. Finally, slow-motion phacoemulsification is used to emulsify and remove the pieces. Viscoexpression of fragments of Soemmerring ring is done if there is a posterior capsulotomy. The residual capsular bag is filled with OVD and a foldable 3-piece IOL injected into the bag and dialed in. This technique allows complete evacuation of Soemmerring ring and placement of a secondary IOL in the capsular bag.
  
  
  BACKGROUND
  Neither author has a financial or proprietary interest in any material or method mentioned.
authors.affiliation: Department of Ophthalmology, Northwestern University Feinberg School of Medicine, Chicago, Illinois 60611, USA.
authors.forename: Dilraj S
authors.initials: DS
authors.lastname: Grewal
authors.forename: Surendra
authors.initials: S
authors.lastname: Basti
mesh_terms: D057866:Anterior Capsule of the Lens / Q000601:surgery*; D001036:Aphakia, Postcataract / Q000601:surgery*; D002809:Chondroitin Sulfates / Q000008:administration & dosage; D004338:Drug Combinations; D006801:Humans; D006820:Hyaluronic Acid / Q000008:administration & dosage; D019654:Lens Implantation, Intraocular / Q000379:methods*
chemical_list: D004338:Drug Combinations; C501944:chondroitin sulfate, sodium hyaluronate drug combination; D006820:Hyaluronic Acid; D002809:Chondroitin Sulfates