Expanding the application of minimally invasive vitrectomy： 23-G vitrectomy via cornea approach for the treatment of infant cataract

Abstract

Objective To determine the curative effect and complications of 23-G vitrectomy via cornea approach for the treatment of infant cataract. Methods Using lenteetomy and vitrectomy via cornea approach. This retrospective study involvesd a total of 28 eyes from 17 infants who suffered from congenital caact. Two incisions were made using a 23-G stab knife in transparent cornea near limbus. Trocars were inserted： one connected to the infusion tube and the other made the vitreous cutter enter anterior c~amber. We performed anterior circular capsulotomy, lentectomy and aspiration, posterior circular capsulotomy, and anterior vitrectomy via cornea approach. For patients older than 2 years old, foldable intraocular lenses （IOLs） were implanted through a tunnel incision of the cornea. For patients under 2 years old, frame glasses were prescribed and the IOLs would be implanted after 2 years old. The intraoperative and postoperative complications and comfort level and inflammatory reaction after surgery were observed. Results No complications occurred during the operations. Four eyes were implanted IOLs at the same time. A day after surgery the patients could blink freely except one who cried due to the corneal epithelial abrasion which healed the next day. Postoperatively all the corneas were clear and the eye showed only mild signs of inflammatory reaction. No hyphema, effusion, hypotony, and hypertension. One week later, all the light congestion faded away. All parents stated their babies＇ visions were well enough to play freely during the follow-up period of 4-50 months. The surgical technique provided a clear 4-6 mmdiametcer visual axis and circular pupil for all eyes. Tile positions of tiwse intraocular h-nses were ccntered at the, pupil area. None, developed posterior c.apsular opacification. Conclusion The 23-Gauge,vitrectomy via comea approach for the treatment of infant calaract has fewer complications and the patients have little disocmfort.The method should be promoted. Key words: Vitrectomy ,23-G,Cataract; Infant; Children