Comparison of Two Intraocular Lens Implantation Techniques in Pediatric Cataract Surgery in Terms of Postoperative Complications

Year 2018, Volume: 35 Issue: 2, 186 - 190, 01.03.2018

Mustafa Erdoğan Cicik Cezmi Doğan Selim Bölükbaşı Mehmet Necdet Cinhüseyinoğlu Osman Şevki Arslan

Abstract

Background: Pediatric cataract surgery differs substantially from adult cataract surgery. Numerous studies have focused on reducing the development of postoperative complications. Aims: To compare two intraocular lens implantation techniques used in pediatric cataract surgery in terms of postoperative complications.Study Design: Case-control study.Methods: Patients who underwent pediatric cataract surgery and intraocular lens implantation between 2008 and 2016 were evaluated in this retrospective study. Patients aged 3-15 years with unilateral or bilateral cataract and without corneal pathology were included in the study. The patients were categorized into the following two groups: those who underwent posterior capsulorhexis and anterior vitrectomy using in-the-bag intraocular lens implantation (group 1) and those who underwent posterior capsulorhexis and intraocular lens implantation with the optic fixed behind the posterior capsulorhexis (group 2). Rates of postoperative visual axis opacification and complications (glaucoma, posterior synechiae, uveitic reaction, and intraocular lens decentration) were evaluated in these groups. The implanted intraocular lenses were either monoblock (AcrySof SN60AT intraocular lens), triple-piece (AcrySof MA60BM intraocular lens) foldable hydrophobic acrylic lenses, or multifocal lenses (AcrySof IQ ReSTOR).Results: This retrospective study included 52 eyes of 37 patients. Group 1 comprised 26 eyes of 20 patients and group 2 comprised 26 eyes of 17 patients. During the follow-up, visual axis opacification was observed in two patients in group 1 but no patients in group 2. Regarding postoperative complications, there was no uveitic reaction, posterior synechiae, or intraocular lens decentration in either group. There was no significant difference between the groups in terms of the postoperative complications (p>0.05). Conclusion: There was no significant difference between in-the-bag intraocular lens implantation after posterior capsulorhexis and intraocular lens optic capture through posterior capsulorhexis in terms of the complications.

Keywords

Cataract, intraocular lens, posterior capsule opacification, posterior capsulorhexis

References

• 1. Wu X, Long E, Lin H, Liu Y. Prevalence and epidemiological characteristics of congenital cataract: a systematic review and meta-analysis. Sci Rep 2016;6:28564.
• 2. Gilbert C, Foster A. Childhood blindness in the context of VISION 2020 the right to sight. Bull World Health Organ 2001;79:227-32.
• 3. Brady KM, Atkinson CS, Kilty LA, Hiles DA. Cataract surgery and intraocular lens implantation in children. Am J Ophthalmol 1995;120:1-9.
• 4. Lambert SR, Drack AV. Infantile cataracts. Surv Ophthalmol 1996;40:427-58.
• 5. Basti S, Greenwald MJ. Principles and paradigms of pediatric cataract management. Indian J Ophthalmol 1995;43:159-76.
• 6. Basti S, Ravishankar U, Gupta S. Results of a prospective evaluation of three methods of management of pediatric cataracts. Ophthalmology 1996;103:713-20.
• 7. Crouch ER Jr, Pressman SH, Crouch ER. Posterior chamber intraocular lenses: long-term results in pediatric cataract patients. J Pediatr Ophthalmol Strabismus 1995;32:210-8.
• 8. Xie L, Dong X, Cao J, Li S. Cataract extraction and intraocular lens implantation with anterior vitrectomy in children. Chin Med J (Engl) 1996;109:243-6.
• 9. Lim ME, Buckley EG, Prakalapakorn SG. Update on congenital cataract surgery management. Curr Opin Ophthalmol 2017;28:87-92.
• 10. Vera L, Lambert N, Sommet J, Boulkedid R, Alberti C, Bui Quoc E. Visual outcomes and complications of cataract surgery with primary implantation in infants. J Fr ophtalmol 2017;40:386-93.
• 11. Keech RV, Tongue AC, Scott WE. Complications after surgery for congenital and infantile cataracts. Am J Ophthalmol 1989;108:136-41.
• 12. Koenig SB, Ruttum MS, Lewandowski MF, Schultz RO. Pseudophakia for traumatic cataracts in children. Ophthalmology 1993;100:1218-24.
• 13. Vasavada A, Desai J. Primary posterior capsulorhexis with and without anterior vitrectomy in congenital cataracts. J Cataract Refract Surg 1997;23(Suppl 1):645-51.
• 14. Zhao YE, Gong XH, Zhu XN, Li HM, Tu MJ, Coursey TG, et al. Long-term outcomes of ciliary sulcus versus capsular bag fixation of intraocular lenses in children: An ultrasound biomicroscopy study. PloS One 2017;12:e0172979.
• 15. Faramarzi A, Javadi MA. Comparison of 2 techniques of intraocular lens implantation in pediatric cataract surgery. J Cataract Refract Surg 2009;35:1040-5.
• 16. Khatib N, Tsumi E, Baidousi A, Nussinovitch H, Bilenko N, Lifshitz T, et al. Infantile cataract: comparison of two surgical approaches. Can J Ophthalmol 2017;52:527-32.
• 17. Gimbel HV. Posterior continuous curvilinear capsulorhexis and optic capture of the intraocular lens to prevent secondary opacification in pediatric cataract surgery. J Cataract Refract Surg 1997;23(Suppl 1):652-6.
• 18. Gimbel HV, DeBroff BM. Posterior capsulorhexis with optic capture: maintaining a clear visual axis after pediatric cataract surgery. J Cataract Refract Surg 1994;20:658- 64.
• 19. Vasavada AR, Trivedi RH, Singh R. Necessity of vitrectomy when optic capture is performed in children older than 5 years. J Cataract Refract Surg 2001;27:1185-93.