Ultrasound Biomicroscopy Imaging of Sclerotomy in Children with Cataract Undergoing 25-Gauge Sutureless Pars Plana Anterior Vitrectomy

Abstract

To investigate the healing course and features of sclerotomy in children with cataract undergoing 25-gauge sutureless pars plana anterior vitrectomy by ultrasound biomicroscopy (UBM) imaging. 25-Gauge sutureless pars plana anterior vitrectomy was performed in 15 eyes for congenital or developmental cataract surgery (mean age 6.9 years, range 5-10 years). Time of anterior vitrectomy, intraoperative and postoperative clinical observations, postoperative complications, and UBM imaging of sclerotomy sites were evaluated. The mean time of anterior vitrectomy was 40.9 seconds (range 26-53 seconds). A stable intraocular pressure and a slight disturbance on vitreous were found intraoperatively. Postoperative inflammation in anterior chamber was mild with fast postoperative recovery. Fluid leakage, vitreous incarceration, hypotony, or any other complications were not noted in any of the eyes. UBM imaging showed that the sclerotomy was detected as a gape through the sclera on day 3 and decreased in size obviously on day 7 after surgery. The internal opening of the gape was cured on postoperative week 2 with inability to detect its internal lip. The scleral wounds in 11 (73.3%) of the eyes were undetectable at week 3 by UBM imaging and all sclerotomy sites were cured at week 4 postoperatively. UBM imaging on pediatric cataract eyes showed that healing of a 25-gauge sclerotomy was rapid and no leakage or vitreous incarceration from the scleral wound was found.