Optic Capture In Microphthalmic Eyes With Congenital Cataract

To describe the surgical challenges in the management of congenital and developmental cataract in children with moderate microphthalmos and to evaluate the safety and feasibility of three-piece intraocular lens (IOL) implantation with optic capture as an alternative to conventional in-the-bag IOL placement.

Tertiary eye care center in North India

This study included 18 eyes of 9 children under 15 years of age with congenital cataract associated with moderate microphthalmos (WTW diameter 8.5–9.5 mm). 

All children underwent EUA. Preoperative assessment included WTW measurement, axial length, keratometry and ultrasound biomicroscopy. IOL power was calculated using the SRK II formula with age-appropriate undercorrection.

Instead of standard single-piece in-the-bag IOL implantation, a three-piece IOL was placed in the sulcus with optic capture through the posterior capsulorhexis.

Visual outcomes, intraocular pressure (IOP), and IOL positioning on 1-month UBM were assessed.

All eyes achieved stable IOL centration with successful optic capture. Postoperative UBM at 1 month confirmed appropriate sulcus positioning and stability of the IOL. Visual outcomes were satisfactory for age, and intraocular pressure remained within normal limits during follow-up. No significant intraoperative or postoperative complications were noted.

Three-piece IOL implantation in the sulcus with optic capture is a safe, stable, and effective alternative to aphakia in selected pediatric patients with moderate microphthalmos where in-the-bag single-piece IOL implantation is technically challenging due to small capsular bag dimensions.