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Updated: Feb 23, 2026
Surgical Correction for Pediatric Epiblepharon and Trichiasis
Published on: July 8, 2025
Twenty-five-gauge sutureless lensectomy in infants with congenital cataract
Marcia Beatriz Tartarella1, João Borges Fortes Filho2
1Department of Ophthalmology, Congenital Cataract Section, Medical School, Federal University of São Paulo UNIFESP, São Paulo SP, Brazil.
Insights
Transconjunctival 25-gauge sutureless lensectomy is a safe and effective treatment for congenital cataracts, with 81% of infants experiencing improved vision and no complications.
Area of Science:
- Ophthalmology
- Pediatric Surgery
- Microsurgery
Background:
- Congenital cataracts significantly impair vision in infants.
- Early intervention is crucial for visual development.
- Surgical techniques aim to minimize invasiveness and complications.
Purpose of the Study:
- To assess the complication rates of transconjunctival 25-gauge sutureless pars plicata lensectomy.
- To evaluate visual acuity outcomes following this minimally invasive procedure in infants.
Main Methods:
- Retrospective review of medical records for infants (<12 months) with congenital cataracts.
- Analysis of intraoperative and postoperative complications up to 90 days and beyond.
- Assessment of visual acuity outcomes at various postoperative intervals.
Main Results:
- Improved visual acuity was observed in 81% of 72 eyes (44 infants).
- Intraoperative adverse events occurred in 13% of eyes.
- Postoperative complications occurred in 19% of eyes, including secondary visual axis opacification (8%) and glaucoma (8%).
Conclusions:
- Transconjunctival 25-gauge sutureless lensectomy is a minimally invasive approach for congenital cataract treatment.
- The procedure demonstrates a high rate of visual acuity improvement (81%).
- A significant majority of eyes (81%) experienced no postoperative complications.
Purpose:
To evaluate the incidence of intra- and postoperative complications of transconjunctival 25-gauge (25G) sutureless pars plicata lensectomy.
Methods:
The medical records of patients <12 months of age with congenital cataracts who underwent 25G sutureless lensectomy were reviewed retrospectively. Patients were evaluated at postoperative days 1, 7, 15, 30, 60, and 90 and every 3 months thereafter. Visual acuity outcomes and intra- and postoperative complications were described and analyzed.
Results:
A total of 72 eyes of 44 infants were included; 28 patients (64%) had bilateral cataract. Median follow-up was 28 months (range, 12-93 months). In 47 eyes (81%) there was improved visual acuity after surgery. Intraoperative adverse events occurred in 9 eyes (13%). Postoperative complications occurred in 14 eyes (19%): 6 eyes (8%) had secondary visual axis opacification, 6 eyes (8%) had secondary glaucoma, 1 eye (1%) had posterior synechiae, and 1 eye (1.4%) had retinal detachment.
Conclusions:
Transconjunctival pars plicata 25G sutureless lensectomy is a minimally invasive technique for congenital cataract treatment. No postoperative complications were observed in 81% of eyes. Visual acuity improved in 81% of the operated eyes.
