Long-term postoperative outcomes of IOL implantation in-the-bag vs optic capture in children up to 4 years of age: randomized, clinical trial

Session Details

Session Title: Cataract Surgery Paediatric/Complications/Management

Session Date/Time: Monday 09/10/2017 | 16:30-18:00

Paper Time: 16:36

Venue: Room 4.1

First Author: : V.Vasavada INDIA

Co Author(s): :    A. Vasavada   S. Vasavada   R. Trivedi              

Abstract Details

Purpose:

Compare visual axis obscuration(VAO) and complications 3 years postoperatively in children <4 years undergoing cataract surgery with intraocular lens(IOL) implantation using two implantation techniques:in-the-bag IOL with anterior vitrectomy versus optic capture of IOL without anterior vitrectomy.

Setting:

Iladevi Cataract & IOL Research Centre, Ahmedabad, India

Methods:

Prospective,randomized,controlled clinical trial including 61 eyes(61 children) upto 4 years of age undergoing cataract surgery with IOL implantation.Eyes randomized to Group I(n=30):in-the-bag three piece hydrophobic acrylic IOL with anterior vitrectomy,or Group II (n=31):optic capture of three piece hydrophobic acrylic IOL without anterior vitrectomy.Children stratified based on age: ≤1 year and >1 year to ≤4 years.Intraoperatively,complications and inability to implant IOL as per plan were documented.Postoperatively, VAO, glaucoma, presence and extent of cell deposits and posterior synechiae compared between groups at 1,2, and 3years postoperatively.Eyes needing membranectomy/vitrectomy documented.

Results:

Mean age in Groups I and II was:14.8±11.47 and 18.2±11.47 months.In 5 eyes in Group II(16.1%),IOL could not be captured.1 eye in Group I developed a VAO needing membranectomy at 4 months follow-up. Two eyes in Group I and none in Group II developed glaucoma until 36 months(p=0.49). The incidence of cell deposits on IOL and posterior synechiae were comparable between groups until 36 months follow-up. No complications occurred in eyes where capture could not be performed.

Conclusions:

Optic capture of three piece hydrophobic acrylic IOL could be achieved in most eyes without a posterior capsule plaque. Despite not performing anterior vitrectomy,there were no significant complications 3 years postoperatively. Optic capture of IOL may eliminate the need for vitrectomy in children <4 years of age.

Financial Disclosure:

NONE