[23-gauge-lentectomy for the treatment of congenital cataract]

Congenital cataract surgery can be performed using a pars plana/plicata approach if placement of an intraocular lens at the time of cataract removal is not a consideration. To prevent development of secondary cataract, we performed lens aspiration, anterior and posterior capsulotomy, and anterior vitrectomy via pars plana or pars plicata approach. Lentectomy in babies should be performed using a minimally invasive technique to prevent complications. Immediately after surgery, insertion of a contact lens should be possible.

The series consisted of 11 eyes of 8 consecutive children who suffered from congenital cataract and underwent pars plana/plicata lentectomy between April 2007 and September 2008. Age at operation ranged from 6 weeks to 13 months (median age 4 months). The inclusion criterion was congenital cataract affecting the visual axis. Lentectomy was performed via a pars plana or pars plicata approach using a special 23-gauge aspiration and irrigation system and a 23-gauge cutter. We performed lens aspiration, anterior and posterior capsulotomy, and anterior vitrectomy.

Postoperatively the eyes showed only mild signs of inflammatory reaction. At the end of the operation, all eyes were provided with contact lenses. For all eyes, the surgical technique provided a clear visual axis during the follow-up period of 2-18 months. One eye developed secondary cataract.

The use of 23-gauge instruments has advantages over standard 20-gauge equipment. Pars plana/plicata lentectomy using 23-gauge instruments is a safe, effective, and minimally invasive method for treating cataract in babies.