Management of congenital cataract in children younger than 1 year using a 25-gauge vitrectomy system.
OBJECTIVE
To evaluate the safety and efficacy of a 25-gauge vitrectomy system for the management of congenital cataract in children younger than 1 year.


METHODS
Princess Margaret Hospital for Children, Western Australia, Australia.


METHODS
Children in a tertiary pediatric hospital and private practice had cataract extraction using a 25-gauge vitrectomy system between January 2005 and June 2008. Each eye had anterior vitrectorhexis, lens aspiration, posterior vitrectorhexis, and anterior vitrectomy through two 25-gauge limbal side ports. The ports were created with a 25-gauge trocar or a 0.6 mm paracentesis knife. The eyes were left aphakic.


RESULTS
Nineteen (95%) of the 20 eyes (14 children) had a successful surgical outcome with the 25-gauge vitrectomy system. One eye was converted to the 20-gauge system because of an unusually tough and fibrous lens capsule. The limbal side ports in 16 of 17 eyes created with the 25-gauge trocar required suturing to seal the ports; none of the 3 eyes with side ports created with the paracentesis knife required suturing. There were no significant intraoperative or postoperative complications other than ocular hypertension in 1 eye.


CONCLUSIONS
The 25-gauge vitrectomy system appears safe and effective for the management of infantile cataract. Advantages include more precise manipulations with smaller instruments in infant eyes, a more stable anterior chamber, and less postoperative astigmatism.
Chee
Kevin Y H
KY
Department of Ophthalmology, Princess Margaret Hospital for Children, Subiaco, Western Australia, Australia.
Lam
Geoffrey C
GC
D001036:Aphakia, Postcataract / Q000209:etiology; D002386:Cataract / Q000151:congenital*; D002387:Cataract Extraction / Q000379:methods*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D007431:Intraoperative Complications; D008297:Male; D008866:Microsurgery / Q000379:methods*; D011182:Postoperative Care; D011183:Postoperative Complications; D012029:Refraction, Ocular; D013396:Suction; D016896:Treatment Outcome; D014821:Vitrectomy / Q000295:instrumentation / Q000379:methods*