Apposition of the anterior and posterior capsule leaflets anterior to the optic may limit the migration of Elschnig pearls, reducing the incidence of secondary membranes and the need for additional procedures.
This maneuver ensures centration of the posterior chamber intraocular lens while eliminating the need for an anterior vitrectomy. Posterior capsulorhexis with optic capture holds promise as a technique for preventing secondary membrane formation. In 13 consecutive eyes operated on in children aged 2 to 12 years (mean, 5.8 years), there was no opacification of the visual axis at a mean follow-up of 19 months after surgery (range, 8-30 years). Results will be compared to an historic cohort of patients with pediatric cataract-intraocular lens who did not have posterior continuous curvilinear capsulorhexis with optic capture. Perioperative complications and incidence of secondary cataract are presented. This technique involves capture of an intraocular lens optic through a posterior curvilinear capsulorhexis opening. In a prospective evaluation, posterior capsulorhexis with optic capture as a surgical technique for preventing secondary membrane formation after pediatric cataract extraction is investigated. The purpose of this article is to investigate a surgical technique for maintaining a clear visual axis after pediatric cataract and intraocular lens surgery. Until ongoing randomized trials are completed, we recommend that surgeons exercise caution before implanting IOLs in the eyes of infants.Ī major concern in pediatric intraocular lens implantation surgery is the high incidence of posterior capsule opacification. A large myopic shift typically occurs that necessitates an initial or a late overcorrection with spectacles or a contact lens, depending on the power of the IOL implanted. IOL implantation during infancy is associated with a high complication rate frequently requiring reoperation.
No preoperative factors could be identified that correlated with the magnitude of the myopic shift. A mean myopic shift of 5.49 D occurred in these eyes a year after surgery. A younger age at the time of surgery was positively correlated with the development of a postoperative complication requiring a reoperation (P =. Complications included open-angle glaucoma (n = 2), lens reproliferation into the visual axis (n = 2), pupillary membranes (n = 2), and corectopia (n = 2). The infants were then followed up for a mean of 13+/-6 months for postoperative complications and longitudinal changes in their refractive error.Įight of the 11 eyes had postoperative complications and were treated with a reoperation. IOLs with a mean power of 26.2+/-2.3 D were implanted using a standardized protocol.
The purpose of this study was to determine the incidence of postoperative complications and the occurrence of myopic shift in infantile eyes after cataract surgery and implantation of an intraocular lens (IOL).Ĭataract surgery and IOL implantation was performed on 11 infants with unilateral congenital cataracts who had a mean age of 10+/-6 weeks at 5 clinical centers. The use of BIL rather than LIB implantation in phacovitrectomy practically eliminates PSI. In the LIB group, these PSI led to 1 case of acute elevation of intraocular pressure by pupillary seclusion and the use of laser iridotomy in 8 cases. Among the risk factors studied, preoperative synechiae and the use of retinal endophotocoagulation were almost significantly associated with the occurrence of PSI (P =. The occurrence of PSI was significantly lower in the BIL group with 1 case (2%) versus 22 cases (40%) in the LIB group (P <. One hundred eyes of 92 patients were included in this study (55 eyes in the LIB group and 45 in the BIL group). A retrospective analysis of the occurrence rate of PSI in the LIB group and in the BIL group was performed, using multivariate analysis including multiple risk factors such as preoperative synechiae, proliferative diabetic retinopathy, use of 20-gauge vitrectomy, use of gas or silicone tamponade, and use of endophotocoagulation. One hundred consecutive cases of phacovitrectomies conducted between May 2013 and July 2016 were included. To compare the rate of posterior synechiae of the iris (PSI) occurrence after phacovitrectomy between a group with lens-in-the-bag (LIB) implantation, that is, implantation in the capsular bag, and a group with bag-in-the-lens (BIL) implantation.ĬHU de Caen, Department of Ophthalmology, Caen, France.
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