What's new AAPOS 2008 - The Private Eye Clinic

capsulectomy and an anterior vitrectomy are performed. Surgical removal of VAO is
usually uncomplicated and rarely has to be repeated.
4. In pediatric eyes with an intact posterior capsule, PCO (Posterior capsular
opacification) develops in most eyes, even those with hydrophobic acrylic IOLs.
However, some studies document a delay in PCO development in eyes with
hydrophobic acrylic IOLs compared with eyes with PMMA IOLs. This delay may allow
the child to reach an age at which he or she can cooperate during an Nd:YAG laser
capsulotomy in the office. Also, during the amblyopic ages, any delay in the onset or
progression of PCO may be beneficial. In children, proliferative PCO is more common
with hydrophobic acrylic IOLs than with PMMA IOLs, with which fibrous PCO is more
common.
5. Patients having cataract surgery during early infancy are at high risk for the
development of glaucoma with or without IOL implantation. Children who have surgery
and IOL implantation later in childhood are at a much lower risk for glaucoma.
6. Finally, an IOL implanted in a child’s eye must remain there for several decades,
perhaps 70 years or more, without biodegrading. To date, hydrophobic acrylic IOLs
have been found to be efficacious in providing good short-term to intermediate-term
results after implantation in pediatric cataract surgery. Longer-tgerm outcomes will
continue to be evaluated.
Comparison of epilenticular IOL implantation vs technique of anterior and
primary posterior capsulorhexis with anterior vitrectomy in paediatric cataract
surgery.
Rastogi A, Monga S, Khurana C, Anand K. Eye. 2007 Nov;21(11):1367-74
This is a prospective comparison of the technique of epilenticular intraocular lens (IOL)
implantation and the technique of anterior continuous curvilinear capsulorhexis
(ACCC), posterior continuous curvilinear capsulorhexis (PCCC) with vitrectomy and inthe-bag
IOL implantation in paediatric cataract surgery. Epilenticular IOL implantation is
performed with the IOl placed over the cataractous lens into the ciliary sulcus. A pars
plana lensectomy and vitrectomy is then performed. Forty eyes of 33 children with
developmental or traumatic cataract, whose mean age was 2-12 years, were randomly
divided into two groups. Group A patients underwent epilenticular IOL implantation while
in group B patients, ACCC, PCCC with anterior vitrectomy with in-the-bag IOL
implantation was performed. Equal number of eyes (10 each) with developmental
cataracts (subgroups A1 and B1) and traumatic cataracts (subgroups A2 and B2) were
allotted to both the groups. RESULTS:. One eye in subgroup B2 developed central
posterior capsular opacification and hence required a secondary capsulotomy. All cases
in group A maintained a clear visual axis at the last follow-up. Minimal postoperative
inflammation was noticed in all groups, which subsided with anti-inflammatory
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