PEDIATRIC CATARACT SURGERY
Abstract
Background. The paper consists of two parts; the first part concentrates on the theoretical foundation of the PCCC surgical technique, while the second part brings forward the results of the study, in which some techniques of cataract surgery were compared.
Methods. The study comprised 22 eyes of 19 children who had their primary cataract surgery performed between 1998 and June 2000. All the patients were operated by one surgeon. Eyes with systemic diseases that cause ectopic lenses were excluded from the study.
In the example of 2 eyes, lensectomy without IOL implantation was performed, whereas in others, PC IOLs were implanted. (15 Baush and Lomb Hydroview, length 12.50 mm and 2 Alcon AcrySof, length 13 mm.)
In 6 eyes, the posterior capsule was left intact (all of the patients were older than 5 years), in 14 eyes PCCC was performed; of these, 13 with and 1 without anterior vitrectomy.
Results. Secondary cataract developed in both aphakic eyes, in 3 eyes with intact posterior capsules, and in 2 eyes that had PCCC. Posterior capsule opacification still remains a major problem in pediatric cataract surgery and IOL implantation, but no other postoperative complications were present. The best visual outcome was achieved in posttraumatic cases, and the worst in children who had associated ocular anomalies.
Conclusions. After early diagnosis and surgery postoperative treatment is also very important. Correction of residual refractive error and orthoptic-pleoptic treatment is necessary for successful visual rehabilitation.
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References
Foster A, Gilbert C, Rahi J. Epidemiology of cataract in childhood. A global perspective. J Cataract Refract Surg 1997; 23: Suppl 1: 601–4.
AAO. Pediatric ophthalmology and strabismus. 1998–9: 238–49.
Kanski JJ. Clinical ophthalmology. Butterworth-Heinman, 1997: 292–4.
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.
Zetterström C, Kugelberg U, Oscarson C. Cataract surgery in children with capsulorhexis of anterior and posterior capsules and heparin-surface-modified intraocular lenses. J Cataract Refract Surg 1994, 20: 599–601.
Sinskey RM, Stoppel JO, Amin P. Long-term results of intraocular lens implantation in pediatric patients. J Cataract Refract Surg 1993; 19: 405–8.
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.
Koch DD. Kohnen retrospective comparison of techniques to prevent secondary cataract formation after posterior chamber intraocular lens implantation in infants and children. J Cataract Refract Surg 1997; 23: 657– 63.
Sharma N, Pushker N, Dada T, Vajpayee BR, Dada VK. Complications of pediatric cataract surgery and intraocular lens implantation. J Cataract Refract Surg 1999; 25: 1585–8.
Vasavada A, Chauhan H. Intraocular lens implantation in infants with congenital cataracts. J Cataract Refract Surg 1994; 20: 592–8.
Vasavada A, Trivedi R. Role of optic capture in congenital cataract and intraocular lens surgery in children. J Cataract Refract Surg 2000; 26: 824–31.
Vasavada A. International medical panel for the advanced of cataract treatment. 1999.
Hutchinson AK, Wilson ME, Saunders RA. Outcomes and ocular growth rates after intraocular lens implantation in the first 2 years of life. J Cataract Refract Surg 1998; 24: 846–52.
McClatchey SK. A comparison of the rate of refractive growth in pediatric aphakic and pseudophakic eyes. Ophthalmology 2000; 107: 118–22.
Cheng KP, Biglan AW. Pediatric cataract surgery. In: Tasman W, Jaeger EA eds. Duane’s clinical ophthalmology. Vol. 6. Philadelphia: Lippincot, 1993: 1–24.
Dahan E, Drusedau MU. Choice of lens and dioptric power in pediatric pseudophakia. J Cataract Refract Surg 1997; 23: Suppl 1: 618–23.
Wilson ME, Apple DJ, Bluestein CE, Wang X. Intraocular lenses for pediatric implantation. Biomaterials, designs, and sizing. J Cataract Refract Surg 1994; 20: 584–91.
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