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S. M. Bar-Sela, N. Birham Har-Noy, A. Spierer; Posterior Capsule Opacification After Congenital Cataract Extraction With Intraocular Lens Implantation. Invest. Ophthalmol. Vis. Sci. 2010;51(13):5405.
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To evaluate the incidence of posterior capsule opacification (PCO) after congenital cataract extraction with intraocular lens implantation, as well as the factors that influence its development and the frequency of procedures required to treat this complication.
A retrospective analysis of clinical data was performed on 65 eyes of 41 patients with congenital cataract who underwent cataract extraction with primary IOL implantation, between the years 1994-2001 at the "Sheba medical center", Israel. The median age at surgery was 42 months (ranging 1 to 135 months), and the median follow up was 34 months (ranging 4 to 90 months). Factors examined included surgical technique (posterior capsulotomy and anterior vitrectomy versus intact posterior capsule and vitreous), type of IOL (PMMA lens versus hydrophobic acrylic lens), incidence of PCO and subsequent intervention to treat it.
27 eyes (43%) developed PCO at mean of 9 months postoperatively (ranging 3 days to 36 months). PCO occurred in 26% of eyes that had posterior capsulotomy and anterior vitrectomy and in 71% of the eyes that had intact posterior capsule and vitreous (P<0.001). There was no correlation between PCO and the patient age at surgery or with IOL material, though with hydrophobic acrylic lenses there was less risk for developing PCO at the first 17 months postoperatively. PCO developed at a mean of 4.2 months after the surgery with the PMMA lens and at a mean of 14.3 months with the hydrophobic acrylic lens. 21 of 27 eyes (78%) with PCO required treatment with Nd:YAG laser capsulotomy.
PCO is a frequent complication after congenital cataract extraction with primary IOL implantation. In order to prevent it posterior capsulotomy and anterior vitrectomy should be done. Acrylic lenses may delay the development of PCO.
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