[Dry pars plana capsulotomy and anterior vitrectomy using 25-gauge vitrectomy system during children cataract surgery]. 2009
OBJECTIVE To describe the initial surgical experience and report the safety and feasibility of dry pars plana capsulotomy and anterior vitrectomy using a 25-gauge vitrectomy system in pediatric cataract surgery. METHODS This was a prospective case series study. After anterior continuous curvilinear capsulorhexis (ACCC) and phacoemulsification with intraocular lens (IOL) implantation in the capsule for all patients, a pars plana capsulotomy and anterior vitrectomy was performed with a 25-gauge vitrectomy system using a dry technique in 40 eyes of 30 children with cataracts. RESULTS All procedures were uneventful and all IOLs were implanted in the capsular bag. No intraoperative complications were noted attributable to the small-gauge instruments. The average follow-up period was eight months (range, 4 to 30). Postoperative intraocular pressure remained stable in most cases, except two eyes (5%) with transient hypotony during the first day after surgery. The postoperative inflammatory response was mild. Ultrasound biomicroscopy showed complete healing of the sclerotomy at four weeks after surgery. No posterior synechia, posterior capsule opacification, IOL capture, vitreous prolapse, choroidal detachment or retinal detachment was observed throughout the follow-up period. CONCLUSIONS Dry pars plana capsulotomy and anterior vitrectomy using a 25-gauge vitrectomy system is safe and effective for the management of posterior lens capsules and anterior vitreous in pediatric cataract surgery. Prospective and comparative study is recommended to evaluate this procedure and traditional method.