title: Completion rates of anterior and posterior continuous curvilinear capsulorrhexis in pediatric cataract surgery for surgery performed by trainee surgeons with the use of a low-cost viscoelastic.
abstract: BACKGROUND
  Pediatric cataract surgery is traditionally done with the aid of high-molecular-weight viscoelastics which are expensive. It needs to be determined if low-cost substitutes are just as successful.
  
  
  OBJECTIVE
  The study aims to determine the success rates for anterior and posterior capsulorrhexis and intraocular lens (IOL) implantation in the bag for pediatric cataract surgery performed with the aid of a low-molecular-weight viscoelastic.
  
  
  METHODS
  Nonrandomized observational study.
  
  
  METHODS
  Children less than 6 years of age who underwent cataract surgery with IOL implantation in the period May 2008-May 2009 were included. The surgeries were done by pediatric ophthalmology fellows. A standard procedure of anterior capsulorrhexis, lens aspiration with primary posterior capsulorrhexis, anterior vitrectomy, and IOL implantation was followed. Three parameters were studied: successful completion of anterior and posterior capsulorrhexis and IOL implantation in the bag.
  
  
  RESULTS
  33 eyes of 28 children were studied. The success rate for completion was 66.7% and 88.2 % for anterior and posterior capsulorrhexis, respectively. IOL implantation in the bag was successful in 87.9%.
  
  
  CONCLUSIONS
  2% hydroxypropylmethylcellulose is a viable low-cost alternative to more expensive options similar to high-molecular-weight viscoelastics. This is of great relevance to hospitals in developing countries.
authors.affiliation: Department of Pediatric Ophthalmology, Aravind Eye Hospital, Madurai, Tamil Nadu, India. rajamanimurali@rediffmail.com
authors.forename: R
authors.initials: R
authors.lastname: Muralidhar
authors.forename: G S
authors.initials: GS
authors.lastname: Siddalinga Swamy
authors.forename: P
authors.initials: P
authors.lastname: Vijayalakshmi
mesh_terms: D019923:Capsulorhexis / Q000191:economics / Q000295:instrumentation / Q000379:methods; D002386:Cataract; D002648:Child; D002675:Child, Preschool; D017046:Cost Savings; D005257:Fellowships and Scholarships / Q000706:statistics & numerical data; D006801:Humans; D065347:Hypromellose Derivatives; D007223:Infant; D019654:Lens Implantation, Intraocular; D008747:Methylcellulose / Q000031:analogs & derivatives* / Q000191:economics / Q000627:therapeutic use; D009885:Ophthalmology / Q000193:education / Q000706:statistics & numerical data*; D055682:Viscoelastic Substances / Q000191:economics / Q000627:therapeutic use*
chemical_list: D055682:Viscoelastic Substances; D065347:Hypromellose Derivatives; D008747:Methylcellulose