Role of optic capture in congenital cataract and intraocular lens surgery in children

Abstract

Purpose To evaluate the role of optic capture in eyes having cataract extraction, anterior vitrectomy, and intraocular lens (IOL) implantation for congenital cataract. Setting Iladevi Cataract & IOL Research Centre, Ahmedabad, India. Methods This prospective study comprised 40 eyes of 28 children, whose mean age was 26.08 months (range 4 to 55 months). Primary posterior continuous curvilinear capsulorhexis, anterior vitrectomy, and IOL implantation were performed in all eyes. Eyes were randomly assigned to 1 of 2 groups of 20 each: in 1 group, optic capture would be used and in the other, the noncapture technique. Permanent optic capture was achieved in 14 eyes, and 26 eyes had no optic capture. Mean follow-up was 16.53 months (range 5 to 24 months). A Student t test and chi-square test were used for statistical analyses. Results All eyes in both groups maintained a clear visual axis. One eye in the optic-capture group developed a membrane in front of the IOL that required a secondary procedure. Posterior synechia formation was significantly greater in the optic-capture group ( P = .04), as were deposits on the IOL optic ( P = .0086). Although all eyes in both groups maintained a clinically centered IOL, geometric decentration was more common in the no-capture group ( P = .0000). Conclusion Optic capture resulted in better IOL centration but predisposed the eye to an increased uveal inflammatory response.