Literature DB >> 31856478

Commentary: Comparison of posterior optic capture of intraocular lens without vitrectomy versus endocapsular implantation with anterior vitrectomy in congenital cataract surgery - A randomized prospective study.

Lav Kochgaway1, Merina Mandal1, Sneha Jain1, Rupak Roy1, Sagar Bhargava1, Maneesh Singh1.   

Abstract

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Year:  2020        PMID: 31856478      PMCID: PMC6951219          DOI: 10.4103/ijo.IJO_2157_19

Source DB:  PubMed          Journal:  Indian J Ophthalmol        ISSN: 0301-4738            Impact factor:   1.848


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Visual axis opacification (VAO) is a major concern for pediatric cataract surgery for its amblyopiogenic nature in this tender age group. To prevent that, several techniques have been advocated in literature.[12] This study has compared posterior optic capture of intraocular lens (IOL) without vitrectomy with in-the-bag IOL and anterior vitrectomy in congenital cataract surgery. The major advantages of optic capture of IOL in pediatric cataract surgery are centration, prevention of herniation of vitreous anteriorly, and prevention of migration of Elschnig pearls on the vitreous face. So vitrectomy can be avoided. This reduces the incidences of VAO and postoperative inflammation. But it requires expertise and so a long learning curve. The results may be comparable, but success of a technique depends on how easily it can be replicated by other surgeons. On that front, probably this technique is at a disadvantage. IOL with primary posterior capsulorhexis (PPC) and anterior vitrectomy is associated with less learning curve as PPC can be done with vitrectomy cutter (vitrectorhexis) instead of manual PPC and the size of PPC is not as crucial as like optic capture. But the main concern is more inflammation. This study has hypothesized that vitreous face disturbance is the main cause of this inflammation. But this is significant only in infant age group. Regarding VAO, there is no difference between the two groups. Though IOL is a controversy in infant cataract surgery due to the facts of VAO, inflammation, and refractive surprises in growing eye, few current studies are favoring primary IOL implantation in infants for a better visual outcome.[34] Though this prospective study of its kind has definitely proved posterior optic capture to be a less traumatic, promising technique for preventing VAO along with less inflammation in pediatric cataract surgery especially in infants,[5] it cannot be generalized. A study using three-piece acrylic and PMMA IOL is needed considering the economic aspect and more availability. How the anterior and posterior capsulorhexis size was measured is not vivid from the methodology.
  4 in total

1.  Posterior continuous curvilinear capsulorhexis and optic capture of the intraocular lens to prevent secondary opacification in pediatric cataract surgery.

Authors:  H V Gimbel
Journal:  J Cataract Refract Surg       Date:  1997       Impact factor: 3.351

2.  Posterior capsulorhexis with optic capture: maintaining a clear visual axis after pediatric cataract surgery.

Authors:  H V Gimbel; B M DeBroff
Journal:  J Cataract Refract Surg       Date:  1994-11       Impact factor: 3.351

3.  Comparison of posterior optic capture of intraocular lens without vitrectomy vs endocapsular implantation with anterior vitrectomy in congenital cataract surgery: A randomized prospective study.

Authors:  Savleen Kaur; Jaspreet Sukhija; Jagat Ram
Journal:  Indian J Ophthalmol       Date:  2020-01       Impact factor: 1.848

4.  Long-term outcomes following primary intraocular lens implantation in infants younger than 6 months.

Authors:  Mithila Negalur; Virender Sachdeva; Srividya Neriyanuri; Mohammed Hasnat Ali; Ramesh Kekunnaya
Journal:  Indian J Ophthalmol       Date:  2018-08       Impact factor: 1.848

  4 in total

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