Surgical Strategies For Addressing Plaques On The Posterior Capsule In Pediatric Cataracts

To assess the occurrence of plaques attached to the posterior capsule during pediatric cataract surgery and evaluate the surgical outcomes after their management 

Khairabad Eye Hospital and Mahendra Eye Institute,Kanpur,India

This retrospective study encompassed pediatric cataract cases up to the age of 14 years, categorized into three groups: Group A (Bilateral Congenital Cataracts),Group B (Unilateral Congenital Cataracts), and Group C (Traumatic Cataracts).Cases with plaques adhered to the posterior capsule were managed either by peeling the membrane using viscoelastics and Utrata forceps or by excising the membrane with vitreoretinal scissors followed by anterior vitrectomy.Intraocular lens (IOL) implantation was performed either in the sulcus or in-the-bag,depending on the surgical requirements.

A total of 473 eyes were operated on, with 98 (20.7%) showing plaques adhered to the posterior capsule. Among the 238 eyes in Group A, 23 (9.7%) had posterior capsular plaques. In Group B, consisting of 67 eyes, 26 (38.8%) presented with posterior capsular plaques, while in Group C, 168 eyes were observed, with 49 (29.2%) showing posterior capsular plaques. A 2-year follow-up revealed a clear visual axis, proper IOL centration, and no significant signs of inflammation. A notably higher percentage of posterior capsular plaques was found in cases of Unilateral Congenital and Traumatic Cataracts.

Effectively managing these plaques through precise and meticulous surgical techniques ensures a clear visual axis and enhances the overall surgical outcome.