Vitrectorhexis versus forceps posterior capsulorhexis in pediatric cataract surgery

Kochgaway, Lav; Biswas, Partha; Paul, Aloke; Sinha, Sourav; Biswas, Rupak; Maity, Puspen; Banerjee, Sumita

doi:10.4103/0301-4738.101066

Cited by 15 publications

(7 citation statements)

References 6 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…A mechanized circular anterior capsulectomy has been proven to be an excellent, safe alternative if the CCC is not possible, and it is the technique of choice. If an IOL is not being implanted, vitrectorhexis is appropriate for use in children under the age of six years, but it increases anterior capsule tear 14, 27, 29, 30…”

Section: Resultsmentioning

confidence: 99%

Updates on managements of pediatric cataract

Mohammadpour

Shaabani

Sahraian

et al. 2019

Journal of Current Ophthalmology

View full text Add to dashboard Cite

Purpose A comprehensive review in congenital cataract management can guide general ophthalmologists in managing such a difficult situation which remains a significant cause of preventable childhood blindness. This review will focus on surgical management, postoperative complications, and intraocular lens (IOL)-related controversies. Methods Electrical records of PubMed, Medline, Google Scholar, and Web of Science from January 1980 to August 2017 were explored using a combination of keywords: "Congenital", "Pediatric", "Childhood", "Cataract", "Lens opacity", "Management", "Surgery", "Complication", "Visual rehabilitation”, and "Lensectomy". A total number of 109 articles were selected for the review process. Results This review article suggests that lens opacity obscuring the red reflex in preverbal children and visual acuity of less than 20/40 is an absolute indication for lens aspiration. For significant lens opacity that leads to a considerable risk of amblyopia, cataract surgery is recommended at 6 weeks of age for unilateral cataract and between 6 and 8 weeks of age for bilateral cases. The recommended approach in operation is lens aspiration via vitrector and posterior capsulotomy and anterior vitrectomy in children younger than six years, and IOL implantation could be considered in patients older than one year. Most articles suggested hydrophobic foldable acrylic posterior chamber intraocular lens (PCIOL) for pediatrics because of lower postoperative inflammation. Regarding the continuous ocular growth and biometric changes in pediatric patients, under correction of IOL power based on the child's age is an acceptable approach. Considering the effects of early and late postoperative complications on the visual outcome, timely detection, and management are of a pivotal importance. In the end, the main parts of post-operation visual rehabilitation are a refractive correction, treatment of concomitant amblyopia, and bifocal correction for children in school age. Conclusions The management of congenital cataracts stands to challenge for most surgeons because of visual development and ocular growth. Children undergoing cataract surgery must be followed lifelong for proper management of early and late postoperative complications. IOL implantation for infants less than 1 year is not recommended, and IOL insertion for children older than 2 years with sufficient capsular support is advised.

show abstract

Section: Resultsmentioning

confidence: 99%

Updates on managements of pediatric cataract

Mohammadpour

Shaabani

Sahraian

et al. 2019

Journal of Current Ophthalmology

View full text Add to dashboard Cite

show abstract

“…Hazirolan et al 12 applied manual anterior and posterior CCC and anterior and posterior vitreous cutter created capsulotomy in congenital cataract and concluded that both techniques appear to be equally safe and effective. Kochgaway et al 13 also found in a series of 50 paediatric cataract cases that the learning curve of vitrectorhexis was quite good, thus can be considered a safe technique. Guo et al 14 summarized in a review article from 2006 that anterior CCC provides the most reliable and tear-resistant capsular opening in paediatric cataract, and vitrectorhexis and radiofrequency diathermy can be approaches depending on the surgeon’s personal preference.…”

Section: Discussionmentioning

confidence: 93%

Vitrectorhexis in penetrating eye injuries in adults

Resch

Balogh

Sándor

et al. 2018

European Journal of Ophthalmology

View full text Add to dashboard Cite

Introduction: Vitrectorhexis is an alternative for manual continuous curvilinear capsulorhexis originally developed for paediatric cataract surgery. The aim of our study was the evaluation of the technique in adult patients with penetrating ocular injury and traumatic cataracts. Methods: Eight eyes of 8 patients (23–41 years, all males) had penetrating mechanical corneal trauma. Anterior lens capsule was penetrated in all cases and additional posterior capsule defect in five cases. Intraocular foreign body was detected in one case in the crystalline lens and in two cases in the posterior segment. Standard 23G infusion cannula and vitreous cutter were applied to perform anterior capsule opening, removal of lens material, anterior vitrectomy and pars plana vitrectomy if needed. No phacoemulsification or irrigation/aspiration probe was used. Results: Vitrectorhexis could be performed in 7 out of 8 cases with the preservation of peripheral anterior capsule; primary implantation of posterior chamber intraocular lens was possible in all cases (in the bag in three eyes and into the sulcus in five eyes). Anterior chamber was stable in all cases intraoperatively, and no dropped nucleus or lens fragment loss was observed. Surgery was combined with pars plana vitrectomy in three cases, with foreign body removal (when necessary). No postoperative complication occurred. Conclusion: Vitrectorhexis was found to be an effective and safe alternative method in the management of complex anterior segment trauma cases. With its use, traditional cataract surgical devices can be substituted and additional benefits of vitreous cutter can be utilized in selected cases, especially in young adults.

show abstract

“…A few important surgical considerations in these cases are performing manual posterior capsulorrhexis vs. using vitrectome, choosing 3-piece PCIOL (with rigid haptics), obtaining adequate optic capture and the learning curve in these cases. Even though prior literature suggests adequate strength of PCC as compared to manual PCC,[ 3 ] at least theoretically and in our personal experience, it is more likely to extend while doing optic capture, so an adequately sized manual capsulorrhexis is important. The only case who developed VAO, had titled IOL, suggests that even with technique, adequate centration is important.…”

mentioning

confidence: 90%