Clinical Outcomes of Pars Plana Posterior Capsulectomy and Anterior Vitrectomy in Pediatric Cataract Surgery
William J. Johnson, MD; M. Edward Wilson, MD; Rupal H. Trivedi, MD
Storm Eye Institute at the Medical University of South Carolina
Introduction: When performing a primary posterior capsulotomy at the time of pediatric cataract and IOL surgery, an anterior or posterior approach can be utilized, with or without a planned anterior vitrectomy. To date, there have been reports of outcomes of the pars plana approach, but additional data is necessary to further elucidate clinical outcomes seen in patients undergoing this surgery. 1
Methods: After IRB exemption, a retrospective analysis was conducted for patients, under 21 years of age, undergoing planned pars plana capsulectomy and anterior vitrectomy at the time of cataract removal with IOL implantation by a pediatric anterior segment surgeon. No cataract etiologies were excluded. The results of clinical characteristics, complications, and outcomes were compiled and statistical parameters calculated.
Results: A total of five hundred-fifty one (551) eyes were included, with a median age at surgery of 3.25 years (range: 11 days-19 years). Fifty-seven were of traumatic etiology (10.3%). Three eyes (0.54%) were diagnosed with retinal detachments during follow-up, none in the perioperative period or the first 18 months after surgery. Visual axis opacification requiring subsequent operative intervention occurred in approximately 10 percent of eyes (58/551). There were no cases of intraoperative hemorrhage or IOL displacement during the procedure and no postoperative endophthalmitis.
Discussion: These data demonstrate the effectiveness and low expected rate of complication using the pars plana approach.
Conclusion: The pars plana approach to posterior capsulectomy and anterior vitrectomy is a clinically safe and effective procedure.
References: 1. Buckley EG, Klombers LA, Seaber JH, et al. Management of the posterior capsule during pediatric intraocular lens implantation. Am J Ophthalmol 1993; 115:722-728.