Optic capture technique prevents PCO after pediatric cataract surgery

Posterior continuous curvilinear capsulorhexis (PCCC) with optic capture of a posterior chamber IOL is a safe and effective technique to afford stable IOL fixation and maintain visual axis clarity after cataract surgery in pediatric eyes, reported Ye Ying Jia, MD. Dr. Jia presented the outcomes from 83 eyes operated on between May 2002 and May 2007. The patients ranged in age from 2 to 14 years (mean 5 years).

Cataract removal was achieved by extracapsular cataract extraction (ECCE) through an anterior continuous curvilinear capsulorhexis measuring 6- to 7-mm. The PCCC was oval in shape and measured 3.5- by 4.5-mm. Anterior vitrectomy was not performed.

Optic capture of the PC-IOL was achieved in 79 eyes (95.2%). At 6 months after surgery, best-corrected distance visual acuity was 20/40 or better in about 52% of eyes. After follow-up of 12 to 36 months, all eyes maintained a clear visual axis Complications included early anterior chamber fibrous exudation (23%) that responded to topical anti-inflammatory treatment, limited iris posterior synechia (16%), and superficial IOL deposits.

"Between 75% and 100% of pediatric eyes develop posterior capsule opacification after ECCE. The technique of PCCC with IOL optic capture prevents this phenomenon by creating tighter contact of the IOL with the posterior capsule to prevent migration of lens epithelial cells. A Soemmering's ring is formed, the capsular sac is blocked, and a clear visual axis maintained," said Dr. Jia.