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Is there any role for endoilluminator in paediatric cataract surgery: a beginner’s perspective

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Session Details

Session Title: Presented Poster Session: IOL Power Calculation/Paediatric

Venue: Poster Village: Pod 1

First Author: : S.Muthu INDIA

Co Author(s): :    J. Matalia   P. Ghalla   P. Panmand        

Abstract Details

Purpose:

Pediatric cataract is one of the important causes of childhood blindness. A significant percentage of these cases are from developing countries like India. Pediatric cataract surgery is a challenge to the novice surgeon and needs a good posterior capsulotomy and anterior vitrectomy to prevent complications. In this prospective observational study we intend to compare the visualization of posterior capsule during posterior capsulorhexis using direct microscope illumination and oblique external illumination using endoilluminator. We also intend to compare completeness of anterior vitrectomy in hands of a novice pediatric surgeon using direct microscope illumination and oblique external illumination using endoilluminator

Setting:

Pediatric Ophthalmology Services,Narayana Nethralaya, Bangalore, India.

Methods:

20 children with pediatric cataract (2 months to 16 years) underwent cataract surgery with primary posterior capsulotomy with anterior vitrectomy (PPC+AV) with or without PCIOL implantation. Cataract surgery was done by the residents by conventional technique using the microscope light initially. Only when the visualilsation of the structures was poor and the resident was unable to visualize the capsule/ vitreous, oblique illumination using endoilluminator light was used to complete the procedure. All cases where assessed for size and regularity of the primary posterior capsulotomy and the completeness of anterior vitrectomy at the end of the procedure by the expert surgeon.

Results:

Of the 20 cases operated, endoilluminator was used in 17 cases (85%) at different stages of the cataract surgery. 6 (35%) of the 17 cases required the use of an endoilluminator to visualize the initial nick made in posterior capsule for posterior capsulotomy. In 10 cases (58.8%) endoilluminator was used to view the vitreous strands and complete anterior vitrectomy. In 2 (11.7%) cases the endoilluminator was used to identify anterior capsular opening. In 3 cases (15%) the resident was able complete the procedure without using endoilluminator which was confirmed by the expert surgeon.

Conclusions:

We would like to conclude endoilluminator is a simple tool to aid in visualization of transparent structures like posterior capsule and vitreous which may be difficult for a resident in pediatric ophthalmology in the earlier period of the training.

Financial Disclosure:

NONE

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