The Long Term Outcome of the Management of the Posterior Capsule in Pseudophakic Children.

This is a long term study of the treatment of the posterior lens capsule in the management of bilateral cataract extraction and insertion of 42 intraocular lenses in 21 children. The purpose of the current study was to compare the long-term outcome of eyes treated by the two different methods of surgery of the posterior lens capsule in bilateral cataract and intraocular lens implantation in children. The author performed an independent ocular exam on the children selected from a consecutive series at 4 different institutions, followed for a minimum of 5 years. The eyes of children in Subgroup A (n=24), had surgery in which an intact capsule was left at the time of initial surgery. The eyes of patients in Subgroup B (n=18) received a primary central lens capsulectomy and limited anterior vitrectomy at the time of the initial surgery. The eyes of Subgroup A (mean age 7.7 years) were found to be in children older than those eyes in Subgroup B (mean age 3.9 years) (P=.001). The eyes in the two subgroups also differed in the necessity of a secondary YAG laser capsulectomy. Twenty one of the 24 eyes in Subgroup A had received a secondary YAG laser capsulectomy and no eyes of the patients in Subgroup B had required a secondary YAG laser capsulectomy at the time of the author's examination (P=.001). A central capsulectomy during the initial surgery was more likely to be chosen for surgery on eyes of younger children (P=.001).