Comparative study of 25- versus 20-gauge pars plana capsulotomy and vitrectomy in pediatric cataract surgery

To compare 25- and 20-gauge pars plana vitrectomy (PPV) for the management of pediatric cataract.

20 eyes of 15 patients were randomly divided into two groups to undergo pars plana capsulotomy and vitrectomy by either 25-gauge (group A) or 20-gauge (group B) PPV after lens aspiration and IOL implantation. The two groups were compared for total surgical time, time taken in doing pars plana capsulotomy and vitrectomy, and the size of posterior capsulotomy. Post-operative astigmatism was compared at 3 months.

The mean total surgical time in group A was 49.2 ± 6.7 min, while mean total surgical time in group B was 62.5 + 5.48 min (p = 0.001). The mean time taken for pars plana capsulotomy and vitrectomy was 4.1 ± 1.19 min in group A and 5.0 ± 0.73 min (p = 0.03) in group B. The mean size of the PCCC in group A was 3.3 ± 0.34 mm, while in group B it was 4.0 ± 0.33 mm (p = 0.001). The mean astigmatism at 3 months in group A was 0.65 ± 0.31 diopters, while in group B it was 1.45 ± 0.92 diopters (p = 0.019).

25-gauge transconjunctival sutureless PPV can be an attractive alternative to 20-gauge system in the management of pediatric cataracts.