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Surgical Correction for Pediatric Epiblepharon and Trichiasis

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Published on: July 8, 2025

Pediatric cataract surgery in buphthalmos.

Jaspreet Sukhija¹, Savleen Kaur, Surinder S Pandav

¹Advanced Eye Centre, Post Graduate Institute of Medical Education and Research, Chandigarh - India.

European Journal of Ophthalmology

|January 16, 2015

Summary

Cataract surgery in children with buphthalmos is challenging. Standard intraocular lens (IOL) implantation is stable, but primary posterior capsulorhexis (PPC) should be avoided to prevent IOL decentration.

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Area of Science:

Ophthalmology
Pediatric Surgery
Glaucoma Management

Background:

Pediatric cataract surgery presents unique challenges, particularly in eyes with buphthalmos (enlarged eyeballs due to congenital glaucoma).
Buphthalmos significantly increases surgical difficulty for cataract removal and intraocular lens (IOL) implantation.

Observation:

The study evaluated 8 eyes of 6 children with buphthalmos undergoing cataract surgery with phacoaspiration and IOL implantation.
Intraocular lens (IOL) implantation was successful in 7 out of 8 eyes.
Primary posterior capsulorhexis (PPC) was performed in 2 eyes, with 100% resulting in IOL decentration.

Findings:

Standard IOLs achieved stability and centration when implanted in the bag or with rhexis fixation.
Primary posterior capsulorhexis (PPC) during the same surgical sitting led to significant IOL decentration.
Membranectomy was required in 3 eyes due to visual axis obscuration.

Implications:

Endocapsular IOL implantation or rhexis fixation are recommended for stable outcomes in pediatric cataract surgery with buphthalmos.
Avoid performing primary posterior capsulorhexis (PPC) concurrently with cataract surgery in buphthalmic eyes to prevent IOL decentration.
Further research may explore alternative techniques to manage the pediatric cataract in buphthalmos.