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N. G. Ziakas, A. N. Vartholomeou, D. G. Mikropoulos, E. Kanonidou, C. Basdekidou, N. S. Georgiadis; Simultaneous Surgery in Bilateral Congenital Cataract and Iol Implantation in a Single Session. Invest. Ophthalmol. Vis. Sci. 2010;51(13):5282.
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To evaluate the safety and efficiency of simultaneous bilateral congenital cataract surgery and IOL implantation in pediatric patients under general anesthesia in a single session.
A retrospective study was carried out on 16 bilateral congenital cataract patients (32 eyes) who presented to the department of pediatric ophthalmology of the Aristotle University of Thessaloniki in the period 2002-2009. All patients underwent bilateral lensectomy and in the bag IOL implantation (Acrysof SN60AT) in a single session under general anesthesia. Patients under 2 years of age underwent primary posterior capsulorrhexis (PCC) and anterior vitrectomy while in older patients the posterior capsule was left intact.
The mean age at cataract surgery was 36.3 months (range 4 months to 10 years) and the mean follow up was 24.6 moths (range 5 months to 3 years). Apart from one eye that developed glaucoma, and another that developed secondary membranes requiring surgical removal, there were no other serious intraoperative or postoperative complications such as posterior capsule rupture, endophthalmitis, strabismus and anesthesia problems. All 5 patients (10 eyes) that did not have PCC, required Yag capsulotomy at 12 months postoperatively. The mean final best corrected VA was 7/10 or better (range 2/10-10/10), two patients required patching and the maximum myopic shift recorded was -3D (range 0-3D).
Simultaneous surgery and IOL implantation in bilateral congenital cataract in a single session under general anesthesia should be taken into consideration. It appears to be safe and efficient while it reduces anesthetic risk, hospital stay and cost and allows immediate visual rehabilitation.
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