Purpose: To evaluate the safety and efficacy of surgical membranectomy with a vitrector via a limbal approach for posterior capsular opacification (PCO) in children.
Methods: In this retrospective analytical interventional study, medical records of children younger than 17 years who underwent surgical membranectomy with anterior vitrectomy via a limbal approach were analyzed. Time lag for PCO formation after cataract surgery was assessed. Any adverse events during surgery, rate of successful completion of membranectomy, postoperative complications, improvement in visual acuity, and intraocular lens (IOL) centration were recorded.
Results: A total of 60 eyes of 58 children were included: 26 had traumatic etiology and 34 had developmental cataract. Mean time duration for PCO formation was 27.83 ± 39.83 months for traumatic cases and 53.53 ± 52.20 months for developmental cataract (P = .04). A satisfactory opening in the center of the membrane was achieved in 47 cases (n = 47, 78.3%). The complications encountered were uveitis (5 eyes), corneal edema (3 eyes), pigment deposition over IOL (2 eyes), raised intraocular pressure (1 eye), IOL drop (1 eye), and broken haptic (1 eye). Membranectomy with posterior optic buttonholing of the IOL in 9 aphakic eyes resulted in good IOL centration, no anterior chamber reaction, and no iris optic capture in the postoperative period. Mean visual acuity improved from 1.16 ± 0.52 to 0.73 ± 0.55 logMAR (P < .001).
Conclusions: Surgical membranectomy with a vitrector via a limbal approach is a safe and effective method for managing PCO in the pediatric population. Posterior optic buttonholing of the IOL during membranectomy or secondary IOL implantation results in good IOL centration and fewer complications. [J Pediatr Ophthalmol Strabismus. 2020;57(1):33-38.].
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