title: Functional outcomes of acrylic intraocular lenses in pediatric cataract surgery.
abstract: OBJECTIVE
  To evaluate the functional outcomes of in-the-bag implantation of acrylic intraocular lenses (IOLs) with posterior continuous curvilinear capsulorhexis (PCCC), without PCCC, with PCCC and anterior vitrectomy, and with PCCC and optic capture in pediatric cataract surgery.
  
  
  METHODS
  Pediatric Ophthalmology Service, Guru Nanak Eye Centre, New Delhi, India.
  
  
  METHODS
  Forty-two eyes of 25 children were included in this prospective study. All eyes had in-the-bag implantation of an AcrySof IOL (Alcon). Twenty-five eyes had had an anterior continuous curvilinear capsulorhexis (ACCC) (Group A). Seventeen eyes had PCCC along with ACCC (Group B), 4 had anterior vitrectomy combined with PCCC (Group C), and 6 had PCCC with IOL optic capture through the PCCC (Group D). Secondary opacification of the visual axis, visual acuity, and possible complications were observed and analyzed.
  
  
  RESULTS
  The mean age of the patients was 78 months (range 36 to 144 months). The mean follow-up was 13 months (range 6 to 18 months). Four eyes (16%) in Group A developed visually significant posterior capsule opacification (PCO) involving the central visual axis and required secondary capsulotomy. All eyes in Groups B, C, and D had a clear visual axis at the last follow-up and did not require a secondary procedure. Minimal postoperative inflammation (ie, aqueous flare and IOL deposits ) was seen in all groups. The mean preoperative decimal best corrected visual acuity (BCVA) in Groups A, B, C, and D was 0.095, 0.055, 0.174, and 0.039, respectively. Postoperatively, the BCVA was 0.54, 0.66, 0.66, and 0.66, respectively.
  
  
  CONCLUSIONS
  An optimal-sized ACCC followed by in-the-bag implantation of a foldable acrylic IOL helped maintain a clear visual axis by delaying the onset of PCO and leading to milder PCO. The benefits of a foldable acrylic IOL in pediatric cataract surgery can be increased by combining it with PCCC, with or without anterior vitrectomy, or with optic capture of the IOL.
authors.affiliation: Pediatric Ophthalmology Service, Guru Nanak Eye Center, Maulana Azad Medical College, New Delhi, India.
authors.forename: Usha K
authors.initials: UK
authors.lastname: Raina
authors.forename: Dinesh K
authors.initials: DK
authors.lastname: Mehta
authors.forename: Sumit
authors.initials: S
authors.lastname: Monga
authors.forename: Ritu
authors.initials: R
authors.lastname: Arora
mesh_terms: D000180:Acrylic Resins; D019923:Capsulorhexis / Q000379:methods; D002648:Child; D002675:Child, Preschool; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D019654:Lens Implantation, Intraocular / Q000379:methods*; D007910:Lenses, Intraocular; D008297:Male; D011183:Postoperative Complications / Q000517:prevention & control; D011446:Prospective Studies; D016896:Treatment Outcome; D014792:Visual Acuity / Q000502:physiology*; D014821:Vitrectomy / Q000379:methods
chemical_list: D000180:Acrylic Resins