Surgical Techniques and Postoperative Complications in Pediatric Cataract Surgery

ABSTRACT

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 NdYAG 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.