Necessity of vitrectomy when optic capture is performed in children older than 5 years.

摘要

PURPOSE: To determine whether anterior vitrectomy is necessary when optic capture is performed in children between 5 and 12 years old with congenital cataract. SETTING: Iladevi Cataract and IOL Research Center, Ahmedabad, India. METHODS: This prospective randomized controlled study comprised 41 eyes of 25 children whose mean age was 83.57 months (range 60 to 144 months). Intraocular lens (IOL) implantation with optic capture through a primary posterior continuous curvilinear capsulorhexis was performed in all the eyes. The IOL haptics were bag fixated. Patients were randomly assigned to 1 of 2 groups. Vitrectomy was performed in 1 group (n = 21 eyes) and not performed in the other group (n = 20 eyes). The mean follow-up was 21.04 months. A Student t test and chi-square test were used for statistical analysis. RESULTS: All eyes in the vitrectomy group and 30% in the no-vitrectomy group had a clear visual axis at the last follow-up (P <.001) The visual axis was obscured as a result of anterior vitreous fibrosis in 70% of eyes in the no-vitrectomy group. High-contrast visual acuity was not significantly different between groups (P =.28). Low-contrast sensitivity was significantly better in the vitrectomy group (P =.02). Eighteen eyes (85.7%) in the vitrectomy group and 16 eyes (80%) in the no-vitrectomy group developed deposits on the IOL (P =.62). The deposits were present at the last follow-up in 4 eyes (19.0%) in the vitrectomy group and in 6 eyes (30.0%) in the no-vitrectomy group (P =.85). Three eyes (14.3%) in the vitrectomy group and 8 eyes (40.0%) in the no-vitrectomy group developed synechias (P =.06). CONCLUSION: The results suggest that anterior vitrectomy is necessary with optic capture in children with congenital cataract who are between 5 and 12 years old.