Role of optic capture in congenital cataract and intraocular lens surgery in children

PURPOSE: To evaluate the role of optic capture in eyes having cataract extraction, anterior vitrectomy, and intraocular lens (IOL) implantation for congenital cataract. SETTING: Iladevi Cataract & IOL Research Centre, Ahmedabad, India. METHODS: This prospective study comprised 40 eyes of 28 children, whose mean age was 26.08 months (range 4 to 55 months). Primary posterior continuous curvilinear capsulorhexis, anterior vitrectomy, and IOL implantation were performed in all eyes. Eyes were randomly assigned to 1 of 2 groups of 20 each: in 1 group, optic capture would be used and in the other, the noncapture technique. Permanent optic capture was achieved in 14 eyes, and 26 eyes had no optic capture. Mean follow-up was 16.53 months (range 5 to 24 months). A Student t test and chi-square test were used for statistical analyses. RESULTS: All eyes in both groups maintained a clear visual axis. One eye in the optic-capture group developed a membrane in front of the IOL that required a secondary procedure. Posterior synechia formation was significantly greater in the optic-capture group (P =.04), as were deposits on the IOL optic (P =.0086). Although all eyes in both groups maintained a clinically centered IOL, geometric decentration was more common in the no-capture group (P =.0000). CONCLUSION: Optic capture resulted in better IOL centration but predisposed the eye to an increased uveal inflammatory response.