Retrospective comparison of surgical techniques to prevent secondary opacification in pediatric cataracts

PURPOSE: To evaluate the effect of different surgical methods for management of the posterior capsule and anterior vitreous on the rate of posterior capsule opacification in pediatric cataracts. METHODS: Charts of 34 children (47 eyes) aged 40 days to 18 years (mean: 8.5 years) who had primary cataract surgery with or without posterior chamber intraocular lens (IOL) implantation during the past 5 years were reviewed. In 26 eyes, cataracts were managed with a posterior continuous curvilinear capsulorhexis, and in 21 eyes, the posterior capsule was left intact. Follow-up averaged 10 months (range: 6.5 months to 5 years). RESULTS: Visually significant secondary cataract developed in nine eyes with intact posterior capsules, and seven eyes required Nd:YAG laser posterior capsulotomy. The average time for YAG capsulotomy postcataract removal in the second group was 4 months. The visual axis remained clear in all eyes that had posterior continuous curvilinear capsulorhexis with or without posterior chamber IOL. Complications such as fibrinoid membrane, stromal edema, posterior synechiae, updrawn pupil, and transient glaucoma occurred in both groups at a similar rate. CONCLUSION: Primary posterior continuous curvilinear capsulorhexis is an effective method for preventing secondary cataract formation in pediatric cataracts.