A new technique of congenital cataract surgery with primary posterior chamber intraocular lens implantation

Tablante, Ronald T.; Cruz, Edward Dennis G.; Lapus, Jaime V.; Santos, Alvin M.

doi:10.1016/s0886-3350(88)80088-9

Cited by 35 publications

(5 citation statements)

References 31 publications

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“…The lens can be approached through the limbus or the pars plana (Goldberg & Peymann 1983; Tablante et al 1988). Using the limbal approach, a high‐viscosity ocular viscosurgical device (OVD) is preferable because the anterior chamber is often shallow and high vitreous pressure is present.…”

Section: Surgical Technique In Childrenmentioning

confidence: 99%

Paediatric cataract surgery

Zetterström

Kugelberg

2007

Acta Ophthalmologica Scandinavica

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. Bilateral congenital cataract is the most common cause of treatable childhood blindness. Nuclear cataract is usually present at birth and is non‐progressive, while lamellar cataract usually develops later and is progressive. Prompt surgery has to be performed in cases with dense congenital cataract: if nystagmus has developed, the amblyopia is unfortunately irreversible. A treatment regime based on surgery within 2 months of life, combined with prompt optical correction of the aphakia and occlusion therapy with frequent follow‐up, have been successful in both unilateral and bilateral cases. The surgery ought to include anterior and posterior capsulorexis in all children at the present time. Intraocular lens implantation has been safely performed below the age of 1 year and has also been successfully performed in bilateral cases. Anterior dry vitrectomy should be performed in preschool children to avoid visual axis opacification. Visual axis opacification is the most common complication found after cataract surgery in children. Secondary glaucoma is by far the most sight‐threatening complication and is, unfortunately, common in the newborn so lifelong follow‐up is essential in these cases.

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Section: Surgical Technique In Childrenmentioning

confidence: 99%

Paediatric cataract surgery

Zetterström

Kugelberg

2007

Acta Ophthalmologica Scandinavica

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“…39,40 Using the limbal approach, a highviscosity ophthalmic viscosurgical device (OVD) is preferable since the anterior chamber is often shallow and has a high vitreous pressure. If the pupil is small, which is common in eyes with congenital cataract, flexible iris retractors can be helpful; 4 are placed in the pupil before the continuous anterior capsulorhexis is performed.…”

Section: Surgical Technique In Childrenmentioning

confidence: 99%

Cataracts in children

Zetterström

Lundvall²,

Kugelberg³

2005

Journal of Cataract and Refractive Surgery

123

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Bilateral congenital cataract is the most common cause of treatable childhood blindness. Nuclear cataract is usually present at birth and is nonprogressive, whereas lamellar cataract usually develops later and is progressive. Surgery must be performed promptly in cases with dense congenital cataract; if nystagmus has developed, the amblyopia is irreversible. A treatment regimen based on surgery within 2 months of birth combined with prompt optical correction of the aphakia and aggressive occlusion therapy with frequent follow-up has been successful in unilateral and bilateral cases. Both anterior and posterior capsulorhexes are performed in most children. Intraocular lens implantation can be performed safely in children older than 1 year. Anterior dry vitrectomy is recommended in preschool children to avoid after-cataract. Opacification of the visual axis is the most common complication of cataract surgery in children. Secondary glaucoma is the most sight-threatening complication and is common if surgery is performed early. Life-long follow-up is essential in these cases.

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“…Some researchers suggested anterior vitrectomy as a routine for primary capsulotomy (Tablante et al. ; Mackool ). Meanwhile, some other researchers, like Vasavada A (Vasavada & Desai ), suggested that anterior vitrectomy should be done along with primary PCCC for congenital cataract children younger than 5 years old because age was a very important issue.…”

Section: Introductionmentioning

confidence: 99%

Efficacy and safety of vitrectomy for congenital cataract surgery: a systematic review and meta‐analysis based on randomized and controlled trials

Cao

Wang

Zhang

et al. 2018

Acta Ophthalmologica

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Purpose To explore the effectiveness and safety of vitrectomy for congenital cataract surgery. Methods We searched PubMed, Science Direct, The Cochrane Library, China National Knowledge Infrastructure and the Wanfang Database. Two researchers extracted data and assessed paper quality independently. Posterior capsule opacification (PCO) or visual axis opacification (VAO), reoperation rate, visual acuity, intraocular lenses (IOL) deposit, synechias, uveitis, secondary glaucoma, low‐contrast sensitivity and IOL decentration were compared. Results We included 11 randomized controlled trials (RCTs) with 634 congenital cataract eyes. Cases of posterior capsule opacification in vitrectomy group were significantly less than that of control group, with risk ratio (RR) of 0.15 [95% confidence interval (CI): 0.09, 0.26], and there was no heterogeneity (I2 = 0%, p = 0.94). Reoperation rate in vitrectomy group was lower than that of control group either (RR = 0.40, 95%CI: 0.17, 0.94), and there was no heterogeneity (I2 = 0%, p = 0.85). Best‐corrected visual acuity (BCVA) measured in LogMAR unit of vitrectomy group was smaller, with a mean difference (MD) of −0.17 (95%CI: −0.28, −0.05), and I2 was only 22%, indicating of a small heterogeneity. No statistical difference was found between two groups on IOL deposit (RR = 1.23, 95%CI: 0.70, 2.17), and the heterogeneity was small (I2 = 16%, p = 0.31). No statistical difference was found between two groups on synechias (RR = 1.08, 95%CI: 0.60, 1.94), with a quite small heterogeneity (I2 = 3%, p = 0.38). No statistical difference was found between two groups on uveitis (RR = 0.55, 95%CI: 0.15, 2.01), and there was no heterogeneity (I2 = 0%, p = 0.94). There was no statistical difference on IOP either, with a MD of 0.25 (95%CI: −1.56, 2.07), and there was no heterogeneity (I2 = 0%). Egger's test showed that there was no publication bias for all assessed outcomes. Low‐contrast sensitivity was better in the vitrectomy group. And no evidence indicated vitrectomy could lead to a higher risk on secondary glaucoma or IOL decentration. Conclusion Vitrectomy helps lower the PCO risk and reoperation risk after congenital cataract surgery, and also, vitrectomy helps patients gain a better BCVA and achieve a better low‐contrast sensitivity, with no trade‐off on IOP control, IOL deposit, synechias, uveitis and secondary glaucoma. We recommend performing vitrectomy during congenital cataract surgery.

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A new technique of congenital cataract surgery with primary posterior chamber intraocular lens implantation

Cited by 35 publications

References 31 publications

Paediatric cataract surgery

Paediatric cataract surgery

Cataracts in children

Efficacy and safety of vitrectomy for congenital cataract surgery: a systematic review and meta‐analysis based on randomized and controlled trials

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