Assessment of intra-operative techniques to prevent visual axis opacification in congenital cataract surgery

Abstract

ObjectiveTo evaluate the effectiveness of various surgical procedures in the management of posterior capsule and anterior vitreous for the prevention of visual axis opacification. Subjects, material and methodsWe retrospectively reviewed 120 eyes operated for unilateral congenital cataracts, with a median age at the time of cataract surgery of 21 months (interquartile range, 6–52 months). The eyes were divided into 3 groups: group 1 (eyes with intact posterior capsule, n=39), group 2 (eyes with posterior continuous curvilinear capsulorhexis, n=38), group 3 (eyes with posterior continuous curvilinear capsulorhexis and anterior vitrectomy, n=43). ResultsTo determine the effect of posterior continuous curvilinear capsulorhexis on visual axis opacification we compared group 2 with group 1 (chi-square Pearson test, P=.281), therefore in this study the implementation of the posterior continuous curvilinear capsulorhexis did not show any decrease in the incidence of visual axis opacification. To study the effect of posterior continuous curvilinear capsulorhexis associated anterior vitrectomy, we compared group 3 with group 1 (chi-square Pearson test, P=.014), demonstrating that the combination of both techniques (posterior continuous curvilinear capsulorhexis and anterior vitrectomy) decreases the incidence of visual axis opacification. ConclusionPosterior continuous curvilinear capsulorhexis as a single technique did not show any decrease in the incidence of visual axis opacification. Posterior continuous curvilinear capsulorhexis together with anterior vitrectomy is required to prevent visual axis opacification and to decrease reoperation rate.