Management of the Anterior and Posterior Lens Capsules and Vitreous in Pediatric Cataract Surgery

Abstract

To review and discuss the advantages and disadvantages of various methods of managing anterior and posterior lens capsules and anterior vitreous in pediatric cataract surgery. We reviewed the literature related to pediatric cataract surgery on PubMed and subclassified the subject into subtopics for managing the anterior lens capsule, posterior lens capsule, and anterior vitreous. After a review of the literature, we summarized the advantages and disadvantages of various approaches related to surgical managements of the anterior lens capsule, posterior lens capsule, and anterior vitreous in pediatric cataract surgery. We discussed recommendations from the literature and commented on our experiences related to the above subtopics. In the surgical management of pediatric cataract, anterior continuous curvilinear capsulorhexis provides the most reliable and tear-resistant capsular opening. Vitrectorhexis and radiofrequency diathermy, on the other hand, are alternative approaches (depending on the surgeon's personal preference). Primary posterior continuous curvilinear capsulorhexis may delay the onset of posterior capsule opacification. Anterior vitrectomy may be necessary to prevent or eliminate the onset of posterior capsule opacification in young children.