Primary posterior capsulorhexis without anterior vitrectomy in pediatric cataract surgery: Longer term outcome

Purpose: To assess the effectiveness of primary posterior capsulorhexis without anterior vitrectomy in preventing posterior capsule opacification (PCO) in pediatric cataract surgery. Setting: Children's Hospital, Dublin, Republic of ireland. Methods: The study comprised 32 eyes of 22 pediatric patients who had cataract extraction between 1994 and 1998. Extracapsular cataract extraction was performed using radiofrequency diathermy capsulorhexis to the anterior and posterior capsules without an anterior vitrectomy. Posterior chamber intraocular lens implantation was performed in 20 eyes. There were 23 congenital, 6 developmental, and 3 traumatic cataracts. Results: Patient age ranged from 1 month to 12 years. Mean follow-up was 19 months (range 6 to 50 months). Twenty-seven of 32 eyes (84.4%) had a clear visual axis at last follow-up. Five eyes required a neodymium:YAG capsulotomy, which was performed a mean of 5 months postoperatively (range 1 to 9 months). The Incidence of PCO requiring capsulotomy was 15.6%. Conclusion: Primary posterior capsulorhexis without anterior vitrectomy was safe and effective, with a low reopacification rate. Long term follow-up of this patient cohort is I necessary. J Cataract Refract Surg 1999; 25:763-767 (C) 1999 ASCRS and ESCRS.