Secondary cataract formation following pediatric intraocular lens implantation: 6-month results

Secondary membrane formation is the most common complication of posterior chamber intraocular lens (PC IOL) implantation in children. The purpose of this study was to determine the effect of various methods of managing the posterior capsule and anterior vitreous on the rate of posterior capsular opacification in children implanted with PC IOLs. We retrospectively studied 16 eyes of 12 children (age 1.5-12 years) implanted with PC IOLs; the follow-up period was at least 6 months. The posterior capsule and anterior vitreous were managed in a variety of ways: in 5 eyes the posterior capsule was left intact, and 11 eyes underwent posterior capsulorehexis (PCCC)-6 cases without and 5 cases with anterior vitrectomy. In two eyes of each of the last two groups, posterior optic capture was performed. Visually significant secondary cataract developed in all five eyes with intact posterior capsules and in the four eyes that had undergone PCCC without vitrectomy and without posterior optic capture. The optical axis remained clear in all eyes that had undergone vitrectomy and in all eyes treated with posterior optic capture. Each procedure, posterior optic capture and anterior vitrectomy appears to be effective in preventing or delaying posterior opacification in lens implantation in infants and children. However, a longterm follow-up is required to determine the efficacy and safety of these two approaches.