Comparison between Limbal and Pars Plana Approaches Using Microincision Vitrectomy for Removal of Congenital Cataracts with Primary Intraocular Lens Implantation

Abstract

Purpose. To compare the surgical outcomes of limbal versus pars plana vitrectomy using the 23-gauge microincision system for removal of congenital cataracts with primary intraocular lens implantation. Methods. We retrospectively reviewed all eyes that underwent cataract removal through limbal or pars plana incision. Main outcome measures included visual outcomes and complications. Results. We included 40 eyes (26 patients) in the limbal group and 41 eyes (30 patients) in the pars plana group. The mean age was 46 months. There was no significant difference in best-corrected visual acuity between the two groups (P = 0.64). Significantly, more eyes had at least one intraoperative complication in the limbal group than in the pars plana group (P = 0.03) that were mainly distributed at 1.5–3 years of age (P = 0.01). The most common intraoperative complications were iris aspiration, iris prolapse, and iris injury. More eyes in the limbal group had postoperative complications and required additional intraocular surgery, but the difference was not significant (P = 0.19). Conclusions. The visual results were encouraging in both approaches. We recommend the pars plana approach for lower incidence of complications. The limbal approach should be reserved for children older than 3 years of age and caution should be exercised to minimize iris disturbance.

Comparison of different surgical approaches for pediatric cataracts: complications and rates of additional surgery during long-term follow-up

“…The higher vitreous pressure observed in infants might explain why they experience more postoperative complications following surgery using a corneal approach. Using a 23-gauge vitrectomy, Lui et al 14 also compared different approaches for primary intraocular lens (IOL) implantation in the bag or in the ciliary sulcus. The authors observed greater numbers of intraoperative and postoperative complications, and a greater number of additional surgeries were performed for patients who underwent surgery using the limbal approach.…”

“…Primary IOL implantation has become more frequent, and research is ongoing to identify better treatments for pediatric cataracts. The literature reports few results comparing surgical approaches, and most of these studies have short-term follow-up periods 14,15. Additional reports are needed to explore the long-term complications in this age group because postoperative complications should be monitored in children throughout life 16,17.…”

The mutation spectrum in familial versus sporadic congenital cataract based on next-generation sequencing

“…Patients who were clinically diagnosed with CC from June 2018 to May 2019 were recruited. All patients underwent a detailed ophthalmic examination, including slit-lamp examination, B ultrasound, intraocular pressure measurement, and ultrasonic A-scan, as mentioned in our previous study [20]. Visual acuity (VA) was recorded in all patients who were able to cooperate.…”

The mutation spectrum in familial versus sporadic congenital cataract based on next-generation sequencing

“…All patients underwent a detailed ophthalmic examination, including slit-lamp examination, B ultrasound, intraocular pressure measurement, and ultrasonic A-scan, as mentioned in our previous study. (20) Visual acuity (VA) was recorded in all patients who were able to cooperate. Patients diagnosed with monocular CC additionally underwent post-eyeball color Doppler ultrasound to help in the differential…”