• Clinics · Jan 2019

    Comparative Study

    Comparison of different surgical approaches for pediatric cataracts: complications and rates of additional surgery during long-term follow-up.

    • Camila R Koch, Newton Kara-Junior, Marcony R Santhiago, and Marta Morales.
    • Departamento de Oftalmologia, Faculdade de Medicina FMUSP, Universidade de Sao Paulo, Sao Paulo, SP, BR.
    • Clinics (Sao Paulo). 2019 Jan 1; 74: e966.

    ObjectivesTo compare long-term postoperative complications of pediatric cataract surgery with primary intraocular lens (IOL) implantation associated with posterior capsulotomy (PC) and anterior vitrectomy (AV) between patients treated with a corneal or pars plicata/pars plana approach.MethodsChildren who underwent cataract surgery with in-the-bag primary IOL implantation were divided into two groups according to PC and AV surgical approach: a corneal approach (group 1) and a pars plicata/pars plana approach (group 2). Only patients with a follow-up duration of more than two years were included. Long-term surgical outcomes were retrospectively reported.ResultsThe mean follow-up period was 10.00±3.13 years. No cases of glaucoma or retinal detachment were reported. The mean age at surgery was 34.57±22.66 months. Forty-six children were included (27 eyes in group 1 and 29 eyes in group 2). The most frequent postoperative complication was corectopia, followed by visual axis opacification. Both complications occurred more frequently in group 1 (p<0.001). After cataract surgery, the rate of additional surgeries in group 1 was 51.9%, while in group 2, the rate was 27.6% (p=0.1132).ConclusionThe pars plicata/pars plana approach with PC and vitrectomy with primary in-the-bag IOL implantation for pediatric cataracts is a safe procedure.

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