1702: capsule polishing or vacuuming?

Believe it or not, cleaning the undersurface of the anterior lens capsule was not always considered a requirement for a beautiful cataract surgery. Years ago our surgical microscopes did not even have a sufficient red reflex to be able to detect these cellular debris. Many surgeons do not spend any time removing this material because it is likely to be dissolved to a degree by the inflammatory cascade in the post-operative period. Certainly there are surgeons who advocate for capsule polishing for virtually every case and that works well in their hands and patient population. If you are inclined to clear this cellular debris, are you using a mechanical method with friction or do you prefer using the I/A probe with mild vacuum settings? Please leave a comment below and let me know your preference and thoughts. This video shows that polishing works, but perhaps vacuuming is better… but there can be capsule complications with vacuuming! (see video)

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  1. I prefer to polish the anterior as well as posterior capsule with a ring polisher after filling the capsular bag with viscoelastic. The dislodged material is then vacuumed by I/A along with the viscoelastic. I prefer this because of inadvertent pulling of Zonular fibres leading to early or late retinal holes.

  2. I dont routinely polish and in a recently work Dr Liliana show that polishing it, COULD increase the chance of late luxation of the bag/lio complex.

  3. I routinely polish the anterior capsule with the I/A on the polish low settings but when this is not enough I proceed with mild vacuum on the normal I/A settings

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