Lensectomy and PCIOL Implantation with versus without Posterior Capsulotomy and Anterior Vitrectomy for Pediatric Cataracts

To compare the visual outcomes and complications of lensectomy and posterior chamber intraocular lens (PCIOL) implantation with or without posterior capsulotomy and anterior vitrectomy in older subjects with pediatric cataracts. Seventeen eyes of 12 children aged 10 to 15 years with congenital or developmental cataracts were randomly divided to two groups. Lensectomy and PCIOL (Alcon Acrysof MA60 AC) implantation was performed with (8 eyes) or without (9 eyes) posterior capsulotomy and anterior vitrectomy. Mean age at the time of surgery was 12.3±1.5 (range 10-15) years and mean follow-up period was 18.7±11.2 (range 6-36) months. Posterior capsule opacification developed in three eyes in the non-vitrectomy group; however, media opacification was mild and capsulotomy was not required in any case. All eyes in the vitrectomy group had a clear visual axis at final follow-up (P=0.2). No significant difference was observed between the two groups in term of visual acuity (P=0.3) or complications. Although posterior capsulotomy and anterior vitrectomy seems to be safe in pediatric cataract surgery, it may not be necessary as a routine procedure in older children.