To study the effectiveness of endoilluminator-assisted anterior vitrectomy for pediatric cataract surgery

Poster Details

First Author: S.Tejwani INDIA

Co Author(s):    J. Matalia   K. Shetty           

Abstract Details

Purpose:

Pediatric cataract surgery warrants a primary posterior capsulotomy with adequate anterior vitrectomy to ensure a clear visual axis. This study was carried out to analyze the usefulness and effectiveness of the endoilluminator in different age groups to help achieve adequate anterior vitrectomy aimed at preventing visual axis opacification in pediatric cataract surgery.

Setting:

A tertiary eye care center in southern India

Methods:

We analysed retrospectively 67 eyes of 38 children and divided them in 3 groups < 1 year (29 eyes of 16 patients), 1 to 2 years (8 eyes of 5 patients) and 2 to 8 years (30 eyes of 17 patients). All these cases underwent lens aspiration with posterior capsulotomy and vitrectomy using endoilluminator with or without intraocular lens implantation (IOL) by a single surgeon with a minimum follow-up of 6 weeks. The endpoint of vitrectomy was the absence of vitreous in the anterior chamber, presence of vitreous phase below and only under the posterior capsular remnant, free of the pupil. Follow-up was done at 6 weeks, 3 monthly thereafter for evidence of visual axis opacification, which was defined as poor red glow on distant direct ophthalmoscopy, significant obscuration of fundus and requirement for second surgery.

Results:

Of 29 eyes in < 1 year group, PCIOL was implanted in 6 eyes while 23 eyes were left aphakic; mean follow up was 18.21 ± 15.11 months (1.5 – 51 months). Of 8 eyes in 1 - 2 years group, PCIOL implanted in 7 eyes while 1 eye left aphakic; mean follow up was 21.88 ± 18.53 months (5 – 51 months). Of 30 eyes in 2 - 8 years group, PCIOL implanted in 29 eyes while 1 eye left aphakic; mean follow up was 15.07 ± 12.26 months (3 – 43 months). At all the follow-ups, in all groups, none of the patients had any evidence of visual axis opacification.

Conclusions:

In pediatric cataract surgery when primary posterior capsulotomy with anterior vitrectomy is mandatory, the endoilluminator provides better visibility of the vitreous and ensures a complete and adequate anterior vitrectomy. This is simple, safe, cost effective and easy to learn technique which helps remove any scaffold and reduce the chances of any posterior capsular opacification thus ensuring a clear visual axis. FINANCIAL DISCLOSURE?: No