Posterior optic buttonholing of intraocular lens implantation through posterior capsulorrhexis margin: A technique of intraocular lens implantation in cases of anterior capsulorrhexis extension in pediatric cataract surgery

• Main Authors: Amit Mohan, Pradhnya Sen, Richa Jain, Chintan Shah, Elesh Jain, Alok Sen
• Format: Article
• Language: English
• Published: Wolters Kluwer Medknow Publications 2021-01-01
• Series: Indian Journal of Ophthalmology
• Subjects: anterior capsulorhexis extension; pediatric cataract; pobh
• Online Access: http://www.ijo.in/article.asp?issn=0301-4738;year=2021;volume=69;issue=4;spage=974;epage=977;aulast=Mohan

This study aimed to evaluate the intra- and postoperative complications of intraocular lens (IOL) implantation with posterior optic buttonholing (POBH) in children that had undergone phacoemulsification irrigation/aspiration for congenital/developmental cataract and experienced complication of anterior capsulorrhexis extension (ACE). A total of 25 eyes of 21 patients were included in the study. A foldable three-piece IOL was implanted into the bag/ciliary sulcus with primary posterior capsulorrhexis and POBH. The visual acuity improved from 2.12 ± 0.69 log MAR to 1.38 ± 0.49 log MAR at 6 months follow-up. Postoperative complications included heightened postoperative inflammation in three patients and temporary corneal edema in two patients. Only one patient had developed posterior capsular opacification (PCO) at 6 months follow-up with mild tilt, while the rest 24 eyes had no PCO formation and adequate IOL centration. The results of this study indicate that a three-piece foldable IOL implantation with POBH is a feasible option for children who experienced ACE during pediatric cataract surgery, as it results in satisfactory surgical outcomes and very few ocular complications.