Visual axis opacification after congenital cataract surgery in the first year of life with or without intraocular lens implantation: more than 5 year follow-up

Session Details

Session Title: Paediatric Ophthalmology & Other Topics

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

Paper Time: 10:18

Venue: Room A3, Podium 2

First Author: : M.Repar Kokalj SLOVENIA

Co Author(s): :    M. Tekavcic Pompe   V. Pfeifer                 

Abstract Details

Purpose:

Visual axis opacification (VAO) is one of the most important reasons for secondary procedures after an early cataract surgery. The purpose of this study was to evaluate VAO in children who underwent congenital cataract surgery within the first year of life at University Eye Hospital Ljubljana from 2009 to 2013, with or without intraocular lens (IOL) implantation. Follow-up was at least 5 years. All eyes were operated by similar surgical technique that included primary posterior-continuous-curvilinear-capsulorhexis (PCCC) with anterior vitrectomy.

Setting:

University Eye Hospital Ljubljana, Slovenia

Methods:

20 children (28 eyes) participated in this retrospective study. All eyes underwent congenital cataract surgery within the first 12 months of life (mean 5.7±2.9months, range: 1.6-11.9). Operated eyes were divided in two groups: pseudophakic, with 3-piece-IOL implanted (n=22), and aphakic (n=6). Pseudophakic eyes were further divided into 5 subgroups according to the IOL position: 1.haptics in-the-bag, optic capture through a PCCC(n=7), 2.in-the-bag IOL without optic capture(n=1), 3.haptics in-the-sulcus, optic capture through an anterior CCC(ACCC) and a PCCC(n=9), 4.in-the-sulcus IOL without optic capture(n=1), 5.haptics in-the-sulcus, optic capture through an ACCC(n=4). Visual axis and number of secondary procedures were evaluated.

Results:

After at least 5-year follow-up (mean 6.5±1.8years, range:5.0-8.9) a secondary procedure was performed to clear visual axis in 2/22 pseudophakic and in 2/6 aphakic eyes. Secondary procedures included removal of Elschnig's pearls in one eye and excision of a membrane anteriorly to the IOL in the second pseudophakic eye, whereas additional core vitrectomy with removal of the membrane within the visual axis was needed in 2 aphakic eyes. The position of the IOL in the eyes that needed secondary procedure was in-the-bag with optic capture through a PCCC(n=1) and in-the-sulcus with optic capture through an ACCC and a PCCC(n=1).

Conclusions:

Visual axis remained clear in more than 90% of eyes with primarily implanted IOL. Surgical technique which included PCCC with anterior vitrectomy, optimally followed by 3-piece-IOL implantation in the capsule with optic capture, proved to be effective in our series of children. Aphakic eyes developed VAO in 30% at the mean follow-up of 6.5 years.

Financial Disclosure:

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