Purpose: To compare surgical outcome of posterior optic capture of intraocular lens (IOL) without anterior vitrec-tomy and endocapsular IOL implantation with anterior vitrectomy in children undergoing cataract surgery. Methods: In this prospective randomised interventional study consecutive children with bilateral congenital/ developmental cataract who were operated over a period of one year were included. One eye of all patients underwent IOL implantation with optic capture through a primary posterior continuous curvilinear capsulorhexis without vitrectomy while in the other eye of the same child IOL was implanted in the bag after a posterior continuous curvilinear capsulorhexis and anterior vitrectomy. Intra-operative challenges and postoperative complications till a follow up of two years were noted. Results: Twenty six eyes of 13 children out of 16 patients were included for analysis. Thirteen eyes had posterior optic capture of IOL and 13 had bag implantation. At a mean follow up of 25.69 ± 1.06 months; all eyes in both groups maintained a clinically centred IOL with no significant visual axis obscuration. The rate of fibrinous complications (IOL deposits and synechiae) were more in the eyes with IOL in the bag (6/ 13) vs eyes where posterior optic capture was done (1/13); p = 0.039. Glaucoma was not observed in any eye. Intra-operative difficulties were comparable and insignificant in either technique. Conclusion: Posterior optic capture is a safer alternative to conventional paediatric cataract surgery in terms of inflammatory sequelae and lens epithelial cell proliferation. However the two methods work equally well in preventing visual axis obscuration over a long follow-up.
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