Surgical Techniques and Postoperative Complications in Pediatric Cataract Surgery

PURPOSE: To evaluate postoperative complications of different surgical techniques in pediatric cataract. METHODS: We retrospectively reviewed 105 eyes of 72 patients who had undergone irrigation and aspiration of cataracts with posterior chamber intraocular lens (IOL) implantation from January 1994 to June 2004. All the eyes were divided into three groups according to the surgical techniques used: group 1 (n=39), IOLs in the bag + intact posterior capsule; group 2 (n=24), IOLs in the bag + posterior continuous curvilinear capsulorhexis (PCCC) + anterior vitrectomy; group 3 (n=42), IOLs in the bag + PCCC + optic capture. Postoperative posterior capsular opacity (PCO), secondary intervention for PCO, strabismus, inflammation, glaucoma, vitreoretinal complications were evaluated. RESULTS: Different from those in the past, current surgical methods for pediatric cataract entail either the optic capture of IOL or anterior vitrectomy through PCCC. PCO is the most frequent postoperative complication. Thirty-five eyes (87.1%) in group 1, 2 eyes (8.3%) in group 2, and no eyes in group 3 developed PCO. Five eyes (33.3%) had recurrence of PCO when PCO was treated by Nd:YAG laser posterior capsulotomy. None had PCO recurrence with secondary optic capture of IOL. Postoperative inflammation and IOL decentration were more common in group 2 than in the other groups. There was no statistically significant difference in the prevalence of postoperative glaucoma between the groups. Neither vitreoretinal complication nor infection was found in our series. CONCLUSIONS: Optic capturing of IOL through PCCC permanently maintains the visual axis with the anterior vitreous face preserved.

Clinical Outcome after Implantation of Intraocular Lens in Pediatric Cataract

Safety and effect of intraocular lens implantation in pediatric cataract patients were studied. And properness of intraocular lens along postoperative refractive changes was evaluated. In the department of ophthalmology, Yeung-Nam University college of medicine, twenty-eight patients were performed lens aspiration with intraocular lens implantation for pediatric cataract from May 1992 to October 1996. Preoperative and postoperative visual acuity, refractive power and postoperative complication along operative methods were evaluated, retrospectively. After follow up period of 6-30 months(mean 17.7 months), visual improvement more than 2 lines was noted 28 eyes(77.8%) by Hahns visual acuity chart. The trends of myopic shift had no significance in statistically, it is proper that we selected intraocular lens power adjust to emmetropia in over 3 years old patients. The difference between preoperative and postoperative refractive power measured within 0 and -2 Diopters in 30 eyes(83%). Aimed intraocular lens power was calculated by using SRK/T fomula for emmetropia and adjustment for refractive error of fellow eye. Best corrected vision was obtained after medical treatment of amblyopia.