Surgical technique and postoperative complications in pediatric cataract surgery: retrospective analysis of 21 cases.
OBJECTIVE
To evaluate postoperative complications of different surgical techniques for cataract treatment in children.


METHODS
We reviewed clinical records of 21 children (33 eyes) who underwent cataract surgery between January 1998 and December 2002. The median age of children at the time of cataract surgery was 39 months (range, 4-115 months). The median follow up was 26 months (range, 6-58 months). A posterior continuous curvilinear capsulorhexis with anterior vitrectomy was performed in 24 eyes, and posterior continuous curvilinear capsulorhexis without anterior vitrectomy in 9 eyes (children older than 7 years). Nine eyes were left aphakic and intraocular lens was implanted in 24 eyes.


RESULTS
Opacification of the visual axis was the most frequent complication. One of nine eyes in the group of children undergoing posterior continuous curvilinear capsulorhexis developed posterior capsule opacification. This also occurred in 6 out of 24 eyes with posterior continuous curvilinear capsulorhexis and anterior vitrectomy. In 5 eyes with secondary opacification Nd:YAG laser capsulotomy was performed as a secondary procedure. In uncooperative children (2 eyes) more extensive anterior vitrectomy was repeated. Other postoperative complications included aphakic glaucoma (n=1), synechia formation (n=4), intraocular lens deposits (n=2), and pupil capture (n=1).


CONCLUSIONS
The main complication in the pediatric cataract surgery was posterior capsule opacification, and the management of posterior capsule seems to be a very important factor. In younger children, cataract surgery with posterior capsulorhexis and anterior vitrectomy was advantageous, whereas in older children a clear visual axis was achieved without vitrectomy.
Petric
Ivanka
I
Eye Clinic, Sisters of Mercy University Hospital, Vinogradska cesta 29, 10000 Zagreb, Croatia. ivankapetric@hotmail.com
Lacmanović Loncar
Valentina
V
D019923:Capsulorhexis / Q000009:adverse effects; D002386:Cataract / Q000151:congenital / Q000503:physiopathology; D002387:Cataract Extraction / Q000009:adverse effects* / Q000379:methods*; D002648:Child; D002675:Child, Preschool; D005260:Female; D006801:Humans; D007223:Infant; D008297:Male; D010372:Pediatrics; D011183:Postoperative Complications / Q000145:classification; D012189:Retrospective Studies; D014821:Vitrectomy / Q000009:adverse effects