Refractive Outcome of Posterior Optic Capture versus Intrabagal Implantation of Intraocular Lenses in Pediatric Cataract Surgery

Purpose: To compare refractive outcome of posterior Optic Capture versus In-the-bag Implantation of Intraocular Lenses in Pediatric Cataract Surgery.

Design: Prospective, randomized and comparative study.

Methods: Forty eyes of 25 children (12 males and 13 females) were included in this study with unilateral or bilateral cataracts in the pediatric age during the period between October 2018 to July 2019. These children were diagnosed to have congenital or developmental cataracts. All children underwent cataract surgery and IOL implantation. In our study, all children were divided into two groups: group (A) included 22 eyes that underwent posterior capsulorhexis and anterior vitrectomy with IOL implantation entirely in the capsular bag and group (B) included 18 eyes that underwent posterior capsulorhexis and posterior optic capture of the IOL. Patient demographics, surgical intervention, presenting symptoms, postoperative refraction and follow up of refractive changes for 6 months were recorded.

Results: Ten cases were unilateral and fifteen cases were bilateral. The mean age was 5.44 ±3.30 in group (A) while the mean age was 4.26±1.45 in group (B). At 1.5 month, the mean spherical error in group (A) was 2.85 ± 1.41 D with range from 1 to 6.5D, and the mean spherical error in group (B) was 2.50 ± 1.70 D with range from -0.75 to 3.75 D with no statistically significant difference in both groups. The mean cylindrical error in group (A) was -0.96 ± 1.87 D with range from -3.5 to 2.25D and the mean cylindrical error in group (B) was -1.38 ± 1.79 D with range from -3 to 2D with no statistically significant difference in both groups. At 6 months, the mean spherical error in group (A) was 0.73 ±1.89 D with range from -4.00 to 3.75D and the mean spherical error in group (B) was 0.00 ± 2.27 D with range from -3.50 to 2.7D with no statistically significant difference in both groups. The mean cylindrical error in group (A) was -1.21± 0.90 D with range from -2.75 to 1.25D and the mean cylindrical error in group (B) was -1.68 ±0.93 D with range from -3.00 to -0.75D with no statistically significant difference in both groups.

Conclusion: There was no statistically significant difference between in-the-bag intraocular lens implantation and intraocular lens posterior optic capture in the term of post-operative refraction. Posterior optic capture helped in preventing posterior capsule opacification (PCO) postoperatively in all cases.