Combined Cataract and Vitrectomy Surgery in Pediatric Patients

Area of Science:

• Ophthalmology
• Pediatric Surgery
• Retinal Surgery

Background:

• Combined lensectomy and vitrectomy (LV) is increasingly utilized in pediatric eye care.
• While lens-sparing vitrectomy (LSV) is often preferred, LV is essential for advanced pediatric ocular pathologies.
• Understanding the nuances of combined LV is critical for optimizing outcomes in children.

Purpose of the Study:

• To review the literature on combined cataract surgery (or lensectomy) and vitrectomy in pediatric patients.
• To analyze clinical indications, surgical techniques, outcomes, and complications.
• To provide insights into managing complex pediatric ocular conditions with combined procedures.

Main Methods:

• A narrative review of published studies was conducted.
• 160 articles were initially identified, with 43 meeting inclusion criteria.
• Studies focused on conditions including congenital cataracts, retinopathy of prematurity, retinal detachment, and persistent fetal vasculature.

Main Results:

• Combined LV can yield favorable anatomical outcomes in pediatric eye diseases.
• Functional visual recovery is variable and depends on age, baseline anatomy, and disease severity.
• Postoperative complications, including glaucoma and visual axis opacification, are more frequent.

Conclusions:

• Combined cataract surgery and vitrectomy is a valuable strategy for complex pediatric ocular conditions when tailored to the individual patient.
• Optimizing both anatomical and functional results requires individualized surgical approaches.
• Further prospective studies and multicenter registries are needed to establish evidence-based guidelines.