25-gauge transconjunctival sutureless vitrectomy system in the surgical management of children with posterior capsular opacification.
OBJECTIVE
To evaluate the safety and efficacy of the 25-gauge transconjunctival sutureless vitrectomy (TSV) system in the surgical management of posterior capsular opacification (PCO) in pseudophakic children.


METHODS
Pars plana membranectomy was performed for PCO in 10 pseudophakic eyes of six children (mean age 35.1 +/- 37.8 months; range 6-93 months) using the TSV system. Surgical technique, intraoperative problems and postoperative complications including wound leakage, hypotony and the need for suturing were recorded.


RESULTS
Wound leakage and other intraoperative problems were not noted in any of the eyes. All eyes showed improvement of visual acuity from a mean of 6/67 before to 6/29 after surgery (P = 0.001). Mean postoperative intraocular pressure (IOP) was 7.8 +/- 3.1 mmHg (range: 3-10 mmHg). Four eyes (40%) had hypotony on the first postoperative day (IOP: 3-5 mmHg), which was transient in three eyes. One eye in a patient with uveitis had persistent hypotony, but hypotony was also present preoperatively, and the postoperative IOP returned to preoperative levels. This eye also developed recurrent PCO and a second capsulotomy was performed using the 25-gauge TSV system.


CONCLUSIONS
Posterior capsulotomy using the 25-gauge TSV system appears to be a safe and effective approach in the management of PCO in pseudophakic children. Advantages include easier manipulation with the smaller instruments in these small eyes, and it can be considered in appropriate cases.
Lam
Dennis S C
DS
Department of Ophthalmology and Visual Sciences, The Chinese University of Hong Kong, Hong Kong Eye Hospital, Kowloon, Hong Kong. dennislam_pub@cuhk.edu.hk
Fan
Dorothy S P
DS
Mohamed
Shaheeda
S
Yu
Christopher B O
CB
Zhang
Shao-bin
SB
Chen
Wei-qi
WQ
D002386:Cataract / Q000628:therapy*; D002648:Child; D002675:Child, Preschool; D003228:Conjunctiva; D005260:Female; D006801:Humans; D007223:Infant; D007429:Intraocular Pressure; D007431:Intraoperative Complications; D007903:Lens Capsule, Crystalline / Q000601:surgery*; D008297:Male; D009339:Needles; D011183:Postoperative Complications / Q000601:surgery*; D011446:Prospective Studies; D019591:Pseudophakia / Q000601:surgery*; D013536:Suture Techniques; D016896:Treatment Outcome; D014821:Vitrectomy / Q000009:adverse effects / Q000379:methods*