Visual axis opacification is the commonest complication of cataract surgery in children. This is a serious complication in this age group because it can lead to sensory deprivation amblyopia. A posterior capsulorhexis with or without anterior vitrectomy is one way to avoid this issue.
Preventive measures for visual axis opacification following pediatric cataract surgery include primary posterior capsulectomy with or without anterior vitrectomy and posterior capsulectomy with capture of the IOL optic without vitrectomy. A range of strategies have been described to manage visual axis opacification such as Nd:YAG laser capsulotomy or membranotomy and pars plana capsulectomy or membranectomy with anterior vitrectomy.
The aim of this work was to determine the safety of performing cataract surgery in children older than two years without performing posterior capsulorhexis. Safety of this technique is determined by detecting the possible intra-operative and post-operative complications, mainly posterior capsular opacification and secondary sensory-deprivation amblyopia.
We reviewed 13 medical records of children above two years who underwent cataract surgery.
Pre-operative, operative and post-operative data were collected, in addition to slit lamp photographs.
Conclusions:
• post-operative visual acuities even after PCO occurrence may encourage ophthalmic surgeons to delay posterior capsulorhexis.
• The surgeon should be experienced enough to operate on these children by ensuring an ideal capsulorhexis and efficient cortical polishing to limit epithelial cell migration.
• The patient should be suitable for YAG-laser; being co-operative enough.
• advantages of this approach would be the less technically challenging operation, the less risk of vitreous loss and retinal traction.