gms | German Medical Science

The implantation technique of Tassignon’s so-called bag-in-the-lens (BIL) comprises the following steps: A 5 mm anterior capsulorhexis is made with the help of a caliper ring. After cataract removal and cleaning the capsular bag, an incision of the posterior capsule is performed and viscoelastic is injected into the retrolenticular space in order to displace the anterior hyaloid and to separate it from the posterior capsule, respectively. This is followed by a posterior capsulorhexis of the same size as the anterior capsulorhexis. Inserting the BIL requires that the edges of the anterior and posterior capsulorhexes be captured by the groove which runs 360° along the rim of the optic.

The removal of the posterior capsule together with the special way of capturing the remaining capsules – much like a tire placed in a bicycle rim – has several advantages: Prevention of a secondary cataract, stable and centered IOL, no posterior synechiae. For these reasons the author uses the described technique /lens routinely in young patients, in patients with uveitis and diabetes and in all combined phaco-vitrectomies cases.