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Posterior continuous curvilinear capsulorhexis with anterior vitrectomy vs optic capture buttonholing without anterior vitrectomy in pediatric cataract surgery. 2022

Thomas Kohnen, and Petra Davidova, and Martin Lambert, and Yaroslava Wenner, and Alina A Zubcov
From the Department of Ophthalmology, Goethe University, Frankfurt, Germany.

To investigate long-term complications after pediatric cataract surgery with implantation of a heparin-coated polymethyl methacrylate intraocular lens (PMMA IOL) and posterior continuous curvilinear capsulorhexis (PCCC) with anterior vitrectomy vs PCCC without anterior vitrectomy with optic capture buttonholing. Department of Ophthalmology, Goethe University, Frankfurt, Germany. Prospective randomized clinical trial. Eyes with unilateral or bilateral congenital cataract without further pathologies or former surgeries were randomly assigned in 2 groups: cataract removal, IOL implantation, and PCCC with anterior vitrectomy (group A) or posterior optic buttonholing without anterior vitrectomy (group B). The main outcome measures were posterior capsule opacification (PCO), complication rates, and refractive development. 58 eyes of 41 pediatric cataract surgery patients were included. The mean age at the time of operation was 66.05 months (±29.39). In group A (n = 26), 2 eyes required treatment for PCO, whereas the optic axis remained clear in all eyes in group B (n = 30), which was statistically insignificant. In addition, group B had a slightly lower rate of complications. The mean spherical equivalent after a mean postoperative follow-up of 6.5 years was -0.11 ± 2.51 diopters (D) (-5.0 to +4.0 D) in group A and -0.08 ± 2.14 D (-5.0 to +4.0 D) in group B, which was also statistically insignificant. Optic capture with a heparin-coated PMMA IOL proved to be a safe technique in the prevention of secondary cataract formation without a higher rate of complications and the necessity of vitrectomy.

UI MeSH Term Description Entries
D007903 Lens Capsule, Crystalline The thin noncellular outer covering of the CRYSTALLINE LENS composed mainly of COLLAGEN TYPE IV and GLYCOSAMINOGLYCANS. It is secreted by the embryonic anterior and posterior epithelium. The embryonic posterior epithelium later disappears. Capsule, Crystalline Lens,Capsules, Crystalline Lens,Crystalline Lens Capsule,Crystalline Lens Capsules,Lens Capsules, Crystalline
D007910 Lenses, Intraocular Artificial implanted lenses. Implantable Contact Lens,Lens, Intraocular,Contact Lens, Implantable,Intraocular Lens,Intraocular Lenses,Lens, Implantable Contact
D011183 Postoperative Complications Pathologic processes that affect patients after a surgical procedure. They may or may not be related to the disease for which the surgery was done, and they may or may not be direct results of the surgery. Complication, Postoperative,Complications, Postoperative,Postoperative Complication
D011446 Prospective Studies Observation of a population for a sufficient number of persons over a sufficient number of years to generate incidence or mortality rates subsequent to the selection of the study group. Prospective Study,Studies, Prospective,Study, Prospective
D002386 Cataract Partial or complete opacity on or in the lens or capsule of one or both eyes, impairing vision or causing blindness. The many kinds of cataract are classified by their morphology (size, shape, location) or etiology (cause and time of occurrence). (Dorland, 27th ed) Cataract, Membranous,Lens Opacities,Pseudoaphakia,Cataracts,Cataracts, Membranous,Lens Opacity,Membranous Cataract,Membranous Cataracts,Opacities, Lens,Opacity, Lens,Pseudoaphakias
D002648 Child A person 6 to 12 years of age. An individual 2 to 5 years old is CHILD, PRESCHOOL. Children
D006493 Heparin A highly acidic mucopolysaccharide formed of equal parts of sulfated D-glucosamine and D-glucuronic acid with sulfaminic bridges. The molecular weight ranges from six to twenty thousand. Heparin occurs in and is obtained from liver, lung, mast cells, etc., of vertebrates. Its function is unknown, but it is used to prevent blood clotting in vivo and vitro, in the form of many different salts. Heparinic Acid,alpha-Heparin,Heparin Sodium,Liquaemin,Sodium Heparin,Unfractionated Heparin,Heparin, Sodium,Heparin, Unfractionated,alpha Heparin
D006801 Humans Members of the species Homo sapiens. Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D014821 Vitrectomy Removal of the whole or part of the vitreous body in treating endophthalmitis, diabetic retinopathy, retinal detachment, intraocular foreign bodies, and some types of glaucoma. Vitrectomies
D019654 Lens Implantation, Intraocular Insertion of an artificial lens to replace the natural CRYSTALLINE LENS after CATARACT EXTRACTION or to supplement the natural lens which is left in place. Implantation, Intraocular Lens,Implantations, Intraocular Lens,Intraocular Lens Implantation,Intraocular Lens Implantations,Lens Implantations, Intraocular

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