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Zhang JS, Wang JD, Yusufu M, Cao K, Jin SS, Xiong Y, Li J, Sun XL, Chen SY, Liu ZY, Fu J, Li L, You QS, Wan XH. The effect of retaining intact posterior capsule in congenital cataract surgery in children aged 4-8 years. BMC Ophthalmol 2021; 21:332. [PMID: 34511057 PMCID: PMC8436493 DOI: 10.1186/s12886-021-02098-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2021] [Accepted: 09/01/2021] [Indexed: 11/18/2022] Open
Abstract
Background The present study sought to observe the effect of retaining intact posterior capsule in congenital cataract surgery in children aged 4–8 years. Methods This is a retrospective case control study. Seventy-seven children (130 eyes) aged from 4 to 8 years who underwent cataract surgery were divided into two groups. In Group A, 50 eyes underwent phacoemulsification, intraocular lens implantation and posterior capsule capsulotomy combined with anterior vitrectomy. In Group B, 80 eyes underwent cataract phacoemulsification and intraocular lens implantation. The postoperative visual acuity and the rate of complications were compared. Results In all patients, cataract surgeries were performed evenly without intraoperative complications. The follow-up time ranged from 6 months to 42 months. No apparent visual axis opacity was detected in group A during the follow-up. By the last visit, apparent visual axis opacity was detected in 31 eyes (38.75%) in group B. Among them, 9 eyes (29.03%) with mild posterior capsule opacification (PCO) were treated with Nd:YAG laser, 3 eyes (9.68%) with thick proliferative membranes were treated with posterior capsule capsulotomy combined with anterior vitrectomy and proliferative membranes in 19 eyes (61.29%) were completely aspired and the posterior capsule was retained. During follow-up, only 2 (6.45%) eyes had PCO recurrence and were treated with Nd:YAG laser. The visual acuity was significantly higher than that before surgery in all patients. Conclusions For older children, the incidence of PCO will be low even if intact posterior capsule is retained. Either Nd:YAG laser or surgical treatment for PCO will be able to maintain good vision.
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Affiliation(s)
- Jing Shang Zhang
- Beijing Institute of Ophthalmology, Beijing Tongren Eye Center, Beijing Tongren Hospital of Capital Medical University, Beijing Key Laboratory of Ophthalmology & Visual Sciences, Beijing, 100005, China
| | - Jin Da Wang
- Beijing Institute of Ophthalmology, Beijing Tongren Eye Center, Beijing Tongren Hospital of Capital Medical University, Beijing Key Laboratory of Ophthalmology & Visual Sciences, Beijing, 100005, China
| | - Mayinuer Yusufu
- Beijing Institute of Ophthalmology, Beijing Tongren Eye Center, Beijing Tongren Hospital of Capital Medical University, Beijing Key Laboratory of Ophthalmology & Visual Sciences, Beijing, 100005, China
| | - Kai Cao
- Beijing Institute of Ophthalmology, Beijing Tongren Eye Center, Beijing Tongren Hospital of Capital Medical University, Beijing Key Laboratory of Ophthalmology & Visual Sciences, Beijing, 100005, China
| | - Shan Shan Jin
- Beijing Institute of Ophthalmology, Beijing Tongren Eye Center, Beijing Tongren Hospital of Capital Medical University, Beijing Key Laboratory of Ophthalmology & Visual Sciences, Beijing, 100005, China
| | - Ying Xiong
- Beijing Tongren Eye Center, Beijing Key Laboratory of Ophthalmology and Visual Sciences, Beijing Tongren Hospital of Capital Medical University, Beijing, 100005, China
| | - Jing Li
- Beijing Tongren Eye Center, Beijing Key Laboratory of Ophthalmology and Visual Sciences, Beijing Tongren Hospital of Capital Medical University, Beijing, 100005, China
| | - Xiu Li Sun
- Beijing Institute of Ophthalmology, Beijing Tongren Eye Center, Beijing Tongren Hospital of Capital Medical University, Beijing Key Laboratory of Ophthalmology & Visual Sciences, Beijing, 100005, China
| | - Shu Ying Chen
- Beijing Institute of Ophthalmology, Beijing Tongren Eye Center, Beijing Tongren Hospital of Capital Medical University, Beijing Key Laboratory of Ophthalmology & Visual Sciences, Beijing, 100005, China
| | - Zhen Yu Liu
- Beijing Institute of Ophthalmology, Beijing Tongren Eye Center, Beijing Tongren Hospital of Capital Medical University, Beijing Key Laboratory of Ophthalmology & Visual Sciences, Beijing, 100005, China
| | - Jing Fu
- Beijing Tongren Eye Center, Beijing Key Laboratory of Ophthalmology and Visual Sciences, Beijing Tongren Hospital of Capital Medical University, Beijing, 100005, China
| | - Li Li
- National Key Discipline of Pediatrics, Ministry of Education, Department of Ophthalmology, Beijing Children's Hospital, Capital Medical University, Beijing, 100045, China
| | - Qi Sheng You
- Casey Eye Institute, Oregon Health Science University, Oregon, USA
| | - Xiu Hua Wan
- Beijing Institute of Ophthalmology, Beijing Tongren Eye Center, Beijing Tongren Hospital of Capital Medical University, Beijing Key Laboratory of Ophthalmology & Visual Sciences, Beijing, 100005, China.
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Adhikari S, Shrestha UD. Pediatric cataract surgery with hydrophilic acrylic intraocular lens implantation in Nepalese children. Clin Ophthalmol 2017; 12:7-11. [PMID: 29339916 PMCID: PMC5745155 DOI: 10.2147/opth.s149806] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/03/2022] Open
Abstract
Purpose To assess the outcome of cataract surgery with hydrophilic acrylic intraocular lens (IOL) implantation in children with congenital and developmental cataracts. Method A retrospective review of medical records of children with congenital or developmental cataracts who underwent cataract surgery with hydrophilic IOL implantation, from January 2011 to December 2014 in a tertiary eye hospital in Nepal. Primary posterior capsulotomy, anterior vitrectomy, and IOL implantation was done in children 8 years or younger, while older children underwent only lens aspiration and IOL implantation. Results A total of 178 eyes of 120 children underwent cataract surgery with primary IOL implantation. Mean age at the time of surgery was 6.9 years (range: 3 months to 15 years). Average follow-up time was 13.7 (±5.9) months. Associated ocular anomalies were present in 84 (47.1%) eyes. Postoperative complications were found in 33 eyes (18.13%) with inflammatory membrane being the most common (10.1%). Two eyes (1.1%) developed endophthalmitis. Second intervention was needed in 12 (6.5%) eyes. Preoperative vision of less than 6/60 was present in 105 eyes (57.69%). Final best corrected visual acuity of 6/12 or better was found in 81 (44.5%) eyes. Conclusion Our study shows that hydrophilic IOL is suitable for use in children. Results of this study are comparable with other studies on pediatric cataract surgeries using hydrophobic acrylic intraocular lenses. Low cost hydrophilic lens implantation is an effective approach in managing pediatric cataract surgery in developing countries like Nepal.
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Affiliation(s)
- Srijana Adhikari
- Department of Pediatric Ophthalmology and Strabismus, Tilganga Institute of Ophthalmology, Kathmandu, Nepal
| | - Ujjowala D Shrestha
- Department of Pediatric Ophthalmology and Strabismus, Tilganga Institute of Ophthalmology, Kathmandu, Nepal
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Sukhija J, Kaur S, Ram J. Outcome of a New Acrylic Intraocular Lens Implantation in Pediatric Cataract. J Pediatr Ophthalmol Strabismus 2015; 52:371-6. [PMID: 26584750 DOI: 10.3928/01913913-20150929-15] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/28/2014] [Accepted: 07/08/2015] [Indexed: 11/20/2022]
Abstract
PURPOSE To study the outcome of Hoya Clear Preloaded intraocular lens (IOL) (PC 60AD, AF Series; Hoya, Tokyo, Japan) implantation in children. METHODS Children who underwent phacoaspiration with primary posterior capsulotomy, anterior vitrectomy, and primary IOL implantation through a 2.8-mm incision were observed prospectively. In all cases, attempts were made to implant the IOL into the capsular bag. Parameters noted were ease of implantation, synechiae formation, IOL deposits, decentration of IOL, visual axis obscuration, haptic compression, and ovalling of the rhexis. Intraoperative complications related to the IOL were also recorded. RESULTS This series comprised 58 eyes of 38 patients with congenital/developmental cataract who underwent implantation of the Hoya IOL. Mean age of the patients was 3.27 ± 2.69 years (range: 3 months to 8 years) and mean follow-up was 24.5 ± 9.13 months. Visual axis obscuration occurred in 4 eyes, posterior synechiae in 5 eyes, IOL deposits in 6 eyes, haptic compression in 3 eyes, and IOL decentration in 1 eye. CONCLUSIONS The data suggest that implantation of the Hoya IOL is a safe option in children undergoing cataract surgery.
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von Sonnleithner C, Bergholz R, Gonnermann J, Klamann MK, Torun N, Bertelmann E. Clinical Results and Higher-Order Aberrations after 1.4-mm Biaxial Cataract Surgery and Implantation of a New Aspheric Intraocular Lens. Ophthalmic Res 2014; 53:8-14. [DOI: 10.1159/000364808] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2014] [Accepted: 05/16/2014] [Indexed: 11/19/2022]
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Sun IT, Kuo HK, Chen YJ, Fang PC, Lin SA, Wu PC, Kuo MT, Teng MC. Long-term results of extraction of childhood cataracts and intraocular lens implantation. Taiwan J Ophthalmol 2013. [DOI: 10.1016/j.tjo.2013.10.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022] Open
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Ram J, Sukhija J, Thapa BR, Arya VK. Comparison of hospital versus rural eye cAMP based pediatric cataract surgery. Middle East Afr J Ophthalmol 2012; 19:141-6. [PMID: 22346130 PMCID: PMC3277013 DOI: 10.4103/0974-9233.92131] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Abstract
Purpose: To compare the outcomes of pediatric cataract surgery with intraocular lens (IOL) implantation in an eye camp setting and tertiary care center. Materials and Methods: Children aged 5-16 years with visually significant cataract underwent phacoaspiration with IOL implantation in an eye camp (eye camp group) or tertiary care center (TCC group). All surgeries incorporated contemporary microsurgical techniques with implantation of polymethyl-methacrylate (PMMA) IOL. Major postoperative complications were managed at a tertiary care center. Postoperative complications, visual acuity and compliance were evaluated using the Chi-square test. A P value less then 0.05 was considered as statistically significant. Results: The cohort comprised 59 children in the eye camp group and 48 children in the TCC group. Thirty two of fifty nine (54.23%) eyes in the eye camp group and 30/48 (62.5%) eyes in the TCC group achieved 20/40 or better best corrected visual acuity (BCVA) postoperatively. Postoperatively, 36 (61%) eyes in the eye camp group and 22 (45.83%) eyes in the TCC group required Nd: YAG laser capsulotomy or a pars plana membranectomy. (P> 0.05) The most striking feature was loss to follow up. In the eye camp group, loss to follow was 20% at one year, 49% at two years, 62% at 3 years and 67% at 4 years compared to 12.5, 21, 27 and 33% respectively in the TCC group (P<0.05, all cases). Conclusions: The outcomes of camp and tertiary care center (hospital) based pediatric cataract surgery were similar. However, the major drawback of camp based surgery was loss to follow up which eventually affected the management of amblyopia and postoperative complications.
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Affiliation(s)
- Jagat Ram
- Advanced Eye Centre, Postgraduate Institute of Medical Education and Research, Chandigarh, India
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Ramchandani S, Ramchandani S. Outcome of in-the-bag implanted square-edge polymethyl methacrylate intraocular lenses with and without posterior capsulotomy in pediatric traumatic cataract. Indian J Ophthalmol 2012; 60:334-5; author reply 335. [PMID: 22824613 PMCID: PMC3442479 DOI: 10.4103/0301-4738.98728] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
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Vasavada AR, Praveen MR, Vasavada VA, Yeh RY, Srivastava S, Koul A, Trivedi RH. Cionni ring and in-the-bag intraocular lens implantation for subluxated lenses: a prospective case series. Am J Ophthalmol 2012; 153:1144-53.e1. [PMID: 22317913 DOI: 10.1016/j.ajo.2011.11.012] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2011] [Revised: 11/02/2011] [Accepted: 11/04/2011] [Indexed: 10/14/2022]
Abstract
PURPOSE To report the intraoperative performance and postoperative outcomes of the Cionni-modified capsule tension ring (CTR) implantation in eyes with subluxated lenses. DESIGN Prospective, observational case series. METHODS This study was carried out at Iladevi Cataract & IOL Research Centre, Ahmedabad, India. The study population comprised 41 eyes with subluxated lenses that underwent lens extraction, capsular bag fixation with modified CTR, and in-the-bag single-piece AcrySof intraocular lens (IOL) implantation. Main outcome measures were intraoperative performance and postoperative best-corrected visual acuity (BCVA), IOL centration, and complications. RESULTS The mean age was 29.46 ± 16.16 years (3-68 years). Mean extent of subluxation was 6.1 ± 1.0 clock hours. Preoperatively, vitreous was detected in the anterior chambers of 5 eyes (12.2%). Two-port anterior chamber vitrectomy was performed in 2 eyes. Mean follow-up was 45.8 ± 2.9 months. Mean preoperative BCVA was 0.66 ± 0.22 logMAR (35 eyes). Mean postoperative BCVA at final follow-up was 0.33 ± 0.21 logMAR (41 eyes) (P < .001). BCVA improved in 35 eyes (85.4%) at the last follow-up. In 3 eyes (7.3%) IOL decentration was noted and repositioning was required in 2 eyes. Posterior capsule opacification developed in 14 eyes (34.2%); 12 eyes (29.3%) required Nd:YAG capsulotomy. Other complications included cystoid macular edema in 1 eye (2.4%), posterior synechiae in 1 eye (2.4%), and retinal detachment in 1 eye (2.4%). CONCLUSION In-the-bag implantation of a Cionni-modified CTR with IOL appears to be a safe option in eyes with subluxated cataract, ensuring a stable IOL with few complications.
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Abstract
PURPOSE Managing pediatric cataracts is often challenging. It is technically difficult to perform surgery in these small complaint eyes and there is higher prevalence of postoperative complications. The outcomes of surgery depend on technique and technology. The purpose of this study is to review the current literature on technological advances in pediatric cataract surgery. METHODS Review of literature on management of pediatric cataract surgery. RESULTS The advent of vitrectomy machines and intraocular lenses (IOLs) has revolutionized pediatric cataract surgery. "Vitrectorhexis" has become a good alternative to manual capsulorhexis. Primary management of posterior capsule and limited anterior vitrectomy has reduced the incidence of visual axis opacification. Primary IOL implantation is becoming a standard of care in the youngest children. Single piece Acrysof® is preferred for in-the-bag implantation and 3-piece Acrysof® for sulcus implantation. Newer IOLs are being evaluated in pediatric eyes. Precise measurement of intraocular lens power and predicting refractive change are major challenges in long term care of children after surgery. CONCLUSION New technology and surgical techniques have refined pediatric cataract surgery. It is critical to focus our efforts on precise biometry measurements, IOL power calculation, and designing IOLs that may address refractive changes in the growing pediatric eye.
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Posterior capsule management in congenital cataract surgery. J Cataract Refract Surg 2011; 37:173-93. [PMID: 21183112 DOI: 10.1016/j.jcrs.2010.10.036] [Citation(s) in RCA: 74] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2010] [Revised: 06/17/2010] [Accepted: 06/26/2010] [Indexed: 11/20/2022]
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Bhusal S, Ram J, Sukhija J, Pandav SS, Kaushik S. Comparison of the outcome of implantation of hydrophobic acrylic versus silicone intraocular lenses in pediatric cataract: prospective randomized study. Can J Ophthalmol 2010; 45:531-6. [DOI: 10.3129/i10-045] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/01/2022]
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Faramarzi A, Javadi MA. Comparison of 2 techniques of intraocular lens implantation in pediatric cataract surgery. J Cataract Refract Surg 2009; 35:1040-5. [DOI: 10.1016/j.jcrs.2009.02.017] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/24/2008] [Revised: 02/02/2009] [Accepted: 02/04/2009] [Indexed: 10/20/2022]
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Vasavada V, Vasavada VA, Hoffman RO, Spencer TS, Kumar RV, Crandall AS. Intraoperative performance and postoperative outcomes of endocapsular ring implantation in pediatric eyes. J Cataract Refract Surg 2008; 34:1499-508. [DOI: 10.1016/j.jcrs.2008.04.044] [Citation(s) in RCA: 35] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2007] [Accepted: 04/16/2008] [Indexed: 10/21/2022]
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Wilson ME, Trivedi RH, Buckley EG, Granet DB, Lambert SR, Plager DA, Sinskey RM, Vasavada AR. ASCRS white paper. Hydrophobic acrylic intraocular lenses in children. J Cataract Refract Surg 2007; 33:1966-73. [PMID: 17964406 DOI: 10.1016/j.jcrs.2007.06.047] [Citation(s) in RCA: 37] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2007] [Accepted: 05/08/2007] [Indexed: 10/22/2022]
Affiliation(s)
- M Edward Wilson
- MUSC--Storm Eye Institute, 167 Ashley Avenue, Charleston, South Carolina 29425-5536, USA.
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Abstract
PURPOSE OF REVIEW The present review will summarize briefly the recent advances in diagnostic tools, surgical techniques, and ophthalmic medications as they relate to the pediatric patient. The review will highlight results from studies that have investigated these new technologies and techniques. RECENT FINDINGS In the past several years there has been a plethora of literature on the application of new technologies and surgical techniques in children. New tools have been used for everything from gathering normative data about the pediatric eye to using the technologies to study diseases such as glaucoma and ocular tumors. Results of surgical techniques such as small-incision cataract surgery, sutureless vitrectomy, and refractive surgery are now reported with regularity in the pediatric ophthalmology literature. SUMMARY In the past 10 years pediatric ophthalmology has made significant advances. Technology has enabled us to qualify and quantify disease states more efficiently, and to explore new surgical techniques for disease processes that were formerly considered relatively untreatable.
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Affiliation(s)
- Kelly A Hutcheson
- Ophthalmology and Pediatrics, Children's National Medical Center, George Washington University, School of Medicine, Washington, District of Columbia 20010, USA.
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Bibliography. Current world literature. Pediatrics and strabismus. Curr Opin Ophthalmol 2007; 18:434-6. [PMID: 17700239 DOI: 10.1097/icu.0b013e3282f0361d] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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