Abstract

DO.12.12

23-gauge-lentectomy for treatment of congenital cataract

Meier P.
Klinik und Poliklinik für Augenheilkunde, Universitätsklinikum, Universität Leipzig

Objective: Congenital cataract surgery can be performed using a pars plana/plicata approach, if placement of an intraocular lens at time of cataract removal is not a consideration. To prevent development of secondary cataract, we performed lens aspiration, anterior and posterior capsulotomy and anterior vitrectomy via pars plana or plicata. Lentectomy in babies should be performed by minimal invasive surgery to prevent complications. Furthermore immediately after operation insertion of a contact lens should be possible.
Methods: The series consisted of 11 eyes from 8 consecutive children who suffered from congenital cataract and underwent pars plana/plicata lentectomy between November 2006 and January 2008. Age at operation was 6 weeks to 18 months (median 3.5 months). Inclusion criterion was congenital cataract affecting the visual axis. Lentectomy was performed via pars plana or pars plicata by using a special 23-gauge-aspiration and irrigation system and a 23-gauge-cutter. We performed lens aspiration, anterior and posterior capsulotomy and anterior vitrectomy.
Results: Postoperatively the eyes showed only mild signs of inflammatory reaction. At the end of operation all eyes were provided with contact lenses. For the operated eyes a follow-up of 2 months to 14 months was available. In all eyes the surgical technique provided a clear visual axis in the time of follow-up, non eye developed secondary cataract.
Conclusions: The use of 23 gauge-instruments has advantage over the use of standard 20-gauge equipment. Pars plana/plicata lentectomy by using 23-gauge instruments is a safe and effective method of minimal invasive surgery for treatment of cataract in babies.

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