Femtosecond laser posterior capsulotomy in paediatric surgery of the primary persistent hyperplastic vitreous

Session Details

Session Title: Paediatric Ophthalmology & Other Topics

Session Date/Time: Tuesday 25/09/2018 | 08:00-10:30

Paper Time: 08:24

Venue: Room A3, Podium 2

First Author: : M. Okuneva RUSSIA

Co Author(s): :    M. Vlasov   A. Tereschenko   I. Trifanenkova              

Abstract Details

Purpose:

To report safety, feasibility and results of posterior capsulotomy in the surgical treatment of pediatric patients with congenital cataracts combined with the syndrome of the primary persistent hyperplastic vitreous (PPHV) using femtosecond laser.

Setting:

Kaluga branch of FGAU «MNTK «Eye Microsurgery» named after acad. S.N. Fedorov»

Methods:

Posterior capsulotomy was performed in ten pediatric patients (10 eyes) with congenital cataracts combined with the PPHV-syndrome using a femtosecond laser (LDV Z8, Ziemer Ophthalmic Systems AG, Switzerland). 6 children with the PPHV-syndrome of severity level 1 and 4 patients with the severity level 2 (Sudovsky classification) were included in the study. The age of the patients at the moment of surgical treatment was between 3 to 12 months. The observation period varied from 8 to 36 months. The feasibility of the method, electroretinography latency and wave amplitude before and after the treatment, intra- and postoperative complications were evaluated.

Results:

An ideally round and smooth posterior capsulotomy of the required diameter was obtained in all cases. It was precisely centered, no bridges were observed in all cases. No difficulties occurred during mobilization of the posterior capsule fragment which was carved for further manipulation. No any intra- or post-operative complications were observed. The ERG Flash postoperative values of the "a" and "b" waves latency and amplitude were significantly improved after the surgery compared to preoperative values. During postoperative period the changes of the functional condition of the retina cones also significantly improved but was assessed as significantly reduced.

Conclusions:

The femtosecond laser assisted technique of the posterior capsulotomy in the surgery of congenital cataract in combination with PPHV -syndrome in pediatric practice allows to achieve a predictable result (ideal shape, precise localization and required diameter), the technique is safe and completely controlled. The use of a low energy femtosecond laser allows optimal anatomical parameters and provides a high and stable functional result. It allows reducing the number of intraocular manipulations, reducing the risk of complications and make shorter the duration of surgery and anesthesia for the children patients.

Financial Disclosure:

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