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Pars plicata lensectomy/vitrectomy for developmental cataract extraction: surgical results
B F Green1, J D Morin, H P Brent
1Department of Ophthalmology, Hospital for Sick Children, Toronto, Canada.
Journal of Pediatric Ophthalmology and Strabismus
|September 1, 1990
Summary
Developmental cataracts removed with pars plicata lensectomy/vitrectomy show few early complications. Small eyes (axial length ≤17.4 mm, corneal diameter ≤9.5 mm) face higher risk of secondary membranes postoperatively.
Area of Science:
- Ophthalmology
- Pediatric Surgery
- Retina
Background:
- Developmental cataracts are a significant cause of visual impairment in children.
- Pars plicata lensectomy/vitrectomy is a surgical technique used for cataract extraction.
- Understanding postoperative complications is crucial for optimizing visual outcomes.
Purpose of the Study:
- To evaluate the early and late complications of pars plicata lensectomy/vitrectomy for developmental cataracts.
- To identify risk factors for postoperative complications, specifically secondary membrane formation.
- To correlate surgical outcomes with ocular dimensions and visual acuity.
Main Methods:
- Retrospective review of 52 cases of developmental cataracts treated with pars plicata lensectomy/vitrectomy.
- Exclusion of eyes with ocular anomalies other than microphthalmos.
- Analysis of postoperative complications, axial length, corneal diameter, and visual acuity.
Main Results:
- No early complications were observed in a follow-up of 1.5 to 7 years (median 4 years).
- Late complications were primarily secondary membranes, occurring in small eyes (axial length ≤17.4 mm, corneal diameter ≤9.5 mm).
- Visual acuity varied based on cataract type (unilateral/bilateral, partial/complete), with median acuities ranging from 20/40 to 20/400.
Conclusions:
- Pars plicata lensectomy/vitrectomy is a safe technique for developmental cataracts with minimal early complications.
- Absolute ocular dimensions, rather than the term 'microphthalmic,' are better predictors of secondary membrane risk.
- Early surgical intervention combined with aggressive visual rehabilitation is essential for achieving optimal visual outcomes in pediatric cataract patients.