Optic Capture Without Anterior Vitrectomy in Pediatric Cataract Surgery

ABSTRACT

Purpose

To compare outcomes of two surgical techniques in children undergoing cataract surgery with intraocular lens (IOL) implantation: optic capture of IOL without anterior vitrectomy (AV) or in-the-bag IOL with AV.

Design

Prospective randomized controlled trial.

Methods

Patients were randomized to two groups: optic capture without AV (Group 1) or in-the-bag implantation with AV (Group 2). The following variables were compared: visual axis opacification (VAO), inflammatory deposits on IOL surface, anterior-posterior synechia, IOL tilt and decentration, lenticular astigmatism, refractive prediction error, and posterior segment complications.

Results

51 eyes of 37 children were investigated with a mean follow-up of 20.1±8.5 months. Group 1 and Group 2 had mean ages of 59.2±32.6 and 46.5±21.9 months, respectively (p=.104). Three eyes in Group 1 and two eyes in Group 2 developed VAO (p=.656). Two eyes in Group 1 and five eyes in Group 2 developed anterior-posterior synechia (p=.291). Six eyes in Group 1 and 11 eyes in Group 2 had inflammatory deposits on the IOL (p=.233). Both groups had similar IOL tilt and decentralization (for all meridians, p>.05). The absolute refractive prediction error was 0.55±0.34 D and 0.53±0.3 D, respectively (p=.294). Each group had one eye with intraocular hypertension (p=.932).

Conclusion

The optic capture method was similar to the conventional technique in the quantitative evaluation of comprehensive data such as visual axis opacification, inflammatory sequelae, refractive outcomes, and IOL stability. The optic capture technique is an appealing option for pediatric cataract surgery since it eliminates the requirement for vitrectomy.