Five-Year Experience of the 2-Incision Push–Pull Technique for Anterior and Posterior Capsulorrhexis in Pediatric Cataract Surgery

PurposeTo describe the authors’ 5-year experience of the 2-incision push–pull (TIPP) technique for pediatric anterior and posterior capsulorrhexis formation.DesignRetrospective descriptive study over a 5-year period.ParticipantsA total of 84 eyes of 63 patients who had undergone cataract surgery in 1 center.MethodsRetrospective review of all consecutive patients who underwent pediatric cataract extraction with planned intraocular lens implantation and TIPP rhexis between January, 1999, and August, 2004. Any lost capsulorrhexis, or capsular tears at any stage of the operation, and the relation of optic size to anterior capsulorrhexis size were noted.Main Outcome MeasuresComplications during TIPP rhexis formation and any late complications at last visit.ResultsThe mean age at operation was 70.21 months (range, 4 weeks–18 years). All eyes had anterior TIPP rhexis; 41 eyes also had posterior TIPP rhexis, and there were no anterior or posterior capsulorrhexis loss or tears while performing the technique. In no patient in whom TIPP rhexis was performed for the posterior capsule was there an inadvertent vitreous loss during rhexis formation. All eyes had anterior rhexis diameters that were smaller than the optic diameter (5.5–6.0 mm), approximately 4 to 4.5 mm in diameter. Four capsular tears were reported; 1 tear occurred during irrigation and aspiration and the others during rigid lens insertion. No late complications were noted.ConclusionsOur 5-year experience with the TIPP rhexis in pediatric cataract surgery has shown this to be a reliable method for producing a consistent-size capsulorrhexis opening in both anterior and posterior capsulorrhexis.