The effect of retaining intact posterior capsule in congenital cataract surgery in children aged 4–8 years

• Main Authors: Jing Shang Zhang, Jin Da Wang, Mayinuer Yusufu, Kai Cao, Shan Shan Jin, Ying Xiong, Jing Li, Xiu Li Sun, Shu Ying Chen, Zhen Yu Liu, Jing Fu, Li Li, Qi Sheng You, Xiu Hua Wan
• Format: Article
• Language: English
• Published: BMC 2021-09-01
• Series: BMC Ophthalmology
• Subjects: Children; Congenital cataract; PCO; Intact posterior capsule
• Online Access: https://doi.org/10.1186/s12886-021-02098-9

Abstract Background The present study sought to observe the effect of retaining intact posterior capsule in congenital cataract surgery in children aged 4–8 years. Methods This is a retrospective case control study. Seventy-seven children (130 eyes) aged from 4 to 8 years who underwent cataract surgery were divided into two groups. In Group A, 50 eyes underwent phacoemulsification, intraocular lens implantation and posterior capsule capsulotomy combined with anterior vitrectomy. In Group B, 80 eyes underwent cataract phacoemulsification and intraocular lens implantation. The postoperative visual acuity and the rate of complications were compared. Results In all patients, cataract surgeries were performed evenly without intraoperative complications. The follow-up time ranged from 6 months to 42 months. No apparent visual axis opacity was detected in group A during the follow-up. By the last visit, apparent visual axis opacity was detected in 31 eyes (38.75%) in group B. Among them, 9 eyes (29.03%) with mild posterior capsule opacification (PCO) were treated with Nd:YAG laser, 3 eyes (9.68%) with thick proliferative membranes were treated with posterior capsule capsulotomy combined with anterior vitrectomy and proliferative membranes in 19 eyes (61.29%) were completely aspired and the posterior capsule was retained. During follow-up, only 2 (6.45%) eyes had PCO recurrence and were treated with Nd:YAG laser. The visual acuity was significantly higher than that before surgery in all patients. Conclusions For older children, the incidence of PCO will be low even if intact posterior capsule is retained. Either Nd:YAG laser or surgical treatment for PCO will be able to maintain good vision.