PRIMARY POSTERIOR CAPSULORHEXIS WITH AND WITHOUT ANTERIOR VITRECTOMY IN CONGENITAL CATARACTS

Purpose: To determine whether anterior vitrectomy is necessary along w ith primary posterior capsulorhexis in children less than 5 years of a ge with congenital cataracts. Setting: Iladevi Cataract & IOL Research Centre, Ahmedabad, India. Method: This prospective study comprised 18 eyes of 16 children whose mean age was 2.3 years (range 3 months to 5 years). Primary posterior continuous curvilinear capsulorhexis (PCCC) and posterior chamber intraocular lens (IOL) implantation were perfor med in all eyes. No vitrectomy was done in 8 eyes (Group 1); an anteri or vitrectomy was performed in 10 eyes (Group 2), Optic capture throug h the posterior capsule was achieved in 3 eyes in Group 1 and in 5 eye s in Group 2, Average follow-up was 13.3 months. Results: Five eyes (6 2.5%) in Group 1 needed secondary pars plana vitrectomy because the vi sual axis was obscured; no eye in Group 2 needed a secondary procedure . Four Group 1 eyes developed significant complications (updrawn pupil , decentration, occlusio pupillae, transient glaucoma). While no Group 2 eye developed a serious complication, some degree of pigment disper sion was noted in all the eyes. Conclusion: The results suggest that a nterior vitrectomy is desirable along with primary PCCC in children yo unger than 5 years with congenital cataracts.