Primary capsulectomy, anterior vitrectomy, lensectomy, and posterior chamber lens implantation in children: Limbal versus pars plana

Purpose: To compare the results of a limbal versus a pars plana approach for primary posterior capsulectomy and anterior vitrectomy in the management of childhood cataract. Setting: Department of Ophthalmology, Labbafinejad Medical Center, Tehran, Iran. Methods: A randomized, controlled, double-masked clinical trial of 45 eyes was conducted. After being matched, 38 eyes were included in the study and were divided into 2 equal groups for data analysis. All eyes had lensectomy and posterior chamber intraocular lens (PC IOL) implantation. Primary posterior capsulectomy and anterior vitrectomy were performed through the limbus in half of the eyes and the pars plana in the other half. Main outcome measures included visual acuity, estimated red reflex, postsurgical inflammatory reaction, corneal clarity, posterior synechias, iris capture, IOL position, capsulectomy size, glaucoma, cystoid macular edema, retinal tear, and postoperative refraction. Results: No statistically significant differences were found between the 2 approaches I in the outcome measures. Conclusion: The anatomic and visual results were encouraging when posterior capsulectomy and anterior vitrectomy, using a limbal or pars plana approach, were combined with lensectomy and PC IOL implantation in children. The application of these techniques depends on surgeon experience and skill. J Cataract Refract Surg 1999; 25:768-775 (C) 1999 ASCRS and ESCRS.