ABSTRACT
Background: Posterior capsule opacification (PCO) is the commonest complication of extracapsular catraract surgery in pediatric patients with an incidence as high as 95%. But there is inadequate evidence on appropriate intervention to prevent PCO. Aim: To compare the efficacy of plasma knife assisted posterior capsulotomy versus manual primary posterior capsulorhexis in Pediatric Cataract surgery. Materials and methods: The current study was a randomized open labeled controlled study, conducted in the department of ophthalmology, All India Institute of Medical Sciences, New Delhi between July 2015 to June 2016. The study population included 32 children in each of < 2 years age, suffering from bilateral cataract and each eye was randomized to different intervention groups consisting of manual posterior capsulorhexis or and posterior capsulotomy using plasma knife. Anterior vitrectomy was performed in all the eyes. Visual acuity, axial length, Intra ocular pressure, and refraction etc. were measured using appropriate methods. The retro-illuminated clinical photograph was taken using NEW CARL ZEISS f340 CANON camera and was analyzed by EPCO software. Prakash S, Giridhar, Harshila Jain. Efficacy of plasma knife assisted posterior capsulotomy versus manual primary posterior capsulorhexis in preventing visual axis opacification in pediatric cataract surgery: A randomized controlled trial. IAIM, 2017; 4(9): 171-177. Page 172 Results: There was no statistically significant difference in any of the ocular parameters at baseline and at 6 months following surgery. The log MAR visual acuity was significantly higher in intervention 1 (0.465±0.143) as compare to intervention 2 (0.397 ± 0.108) at 1 year, which was statistically significant (P value 0.036). There were no statistically significant differences in the proportion of Visual Axis Opacification (VAO) between the intervention groups. Conclusion: Visual axis opacification after pediatric cataract surgery remains comparable in both techniques at one year (plasma knife assisted posterior capsulotomy and manual capsulorhexis). Hence it can be concluded that plasma knife assisted posterior capsulotomy does not have any added advantage over manual posterior capsulorhexis in preventing visual axis opacification.
ABSTRACT
This study was done to compare the results of posterior continuous curvilinear capsulorhexis created using forceps with those created using vitrector in eyes suffering from congenital cataract. Vitrectorhexis term was first used by Wilson et al in 1999.[1] Fifty eyes with congenital and developmental cataract were included in this study. The posterior capsulorhexis was created using utrata forceps in 17 eyes or through a vitrector in 33 eyes. Forceps capsulorhexis was performed before IOL implantation, while vitrectorhexis was performed after IOL implantation in the bag. The results of both the surgery were compared using the following criteria: incidence of extension of rhexis, ability to achieve posterior rhexis of appropriate size, ability to implant the IOL in the bag, the surgical time, and learning curve. Vitrectorhexis after IOL implantation was an easy to learn alternative to manual posterior continuous curvilinear capsulorhexis in pediatric cataract surgery. It was more predictable and reproducible, with a short learning curve and lesser surgical time.
ABSTRACT
PURPOSE: To evaluate the safety and efficacy of transpupillary silicone oil removal using posterior capsulorhexis (PCCC) combined with phacoemulsification and intraocular lens (IOL) implantation. METHODS: We retrospectively reviewed 25 eyes of 25 patients who had undergone silicone oil removal through PCCC from December 1998 to August 2004. IOLs were placed in the bag or in the sulcus after the silicone oil was removed using PCCC. Preoperative and postoperative best corrected visual acuity, refractive error, intraocular pressure (IOP), silicone oil removal time, slit lamp examination, and specular microscopy were evaluated. RESULTS: After the surgery, visual acuity improved in 23 eyes (92%) and a refractive error deviation of 0.5 diopter or more compared with targeted refractive error was found in 13 eyes (52%). Re-detachment of the retina occurred in 3 eyes (12%), increased IOP was observed in 4 eyes (16%), and transient corneal edema in 2 eyes (8%). Endothelial cell count decreased significantly after the operation (P<0.01). However, this change was not statistically significant compared to that of the control group, where only the phacoemulsification was performed. CONCLUSIONS: Silicone oil removal through PCCC after phacoemulsification may be one of the best surgical options for patients who need cataract surgery along with silicone oil removal, provided that the retina is stable and no additional procedures such as membrane peeling, are necessary.
Subject(s)
Humans , Capsulorhexis , Cataract , Corneal Edema , Endothelial Cells , Intraocular Pressure , Lens Implantation, Intraocular , Lenses, Intraocular , Membranes , Microscopy , Phacoemulsification , Refractive Errors , Retina , Retrospective Studies , Silicone Oils , Visual AcuityABSTRACT
This study evaluated the surgical outcome of various surgical technique in paediatric cataract implant surgery, at Jakarta Eye Center, Jakarta, Indonesia. This was a retrospective study of 57 eyes in 44 children who had primary cataract implants surgery. Three surgical techniques used were : 1. Extracapsular cataract extraction with intraocular lens implantation with intact posterior capsule which was performed on 21 eyes (group 1). 2. Extracapsular cataract extraction with intraocular lens implantation and posterior capsulorhexis (PCCC) and optic capture which was performed on 24 eyes (group 2). 3. Extracapsular cataract extraction with intraocular lens implantation, posterior capsulorhexis and anterior vitrectomy which was performed on 24 eyes (group 3). All patients were followed up more than one year. Our results showed that posterior capsule opacity (PCO) was developed in 20 eyes with intact capsules in group 1. All eyes had a clear visual axis in group 2. PCO developed only in one eye in group 3. In conclusion, PCCC and optic capture with or without anterior vitrectomy are effective methods in preventing PCO in infant and children.