comparison of two surgical techniques for intraocular lens implantation in pediatric cataract surgery

purpose: to compare the results of implantation of intraocular lens (iol) haptics in ciliary sulcus versus optic capture through the posterior capsulorrhexis following iol implantation in capsular bag in pediatric cataract surgery. methods: eighteen eyes of nine children with bilateral congenital or developmental cataract were included in this contralateral prospective randomized study. all cases underwent anterior capsulorrhexis, lens aspiration, posterior capsulorrhexis and anterior vitrectomy. in one eye, iol (acrysof ma60bm) was implanted in capsular bag and in the follow eye, iol haptics were implanted in ciliary sulcus and optic was captured through the posterior capsulorrhexis. position of the iol in the first eye was randomly selected. best-corrected visual acuity (bcva), visual axis opacification and possible complications were evaluated. results: mean age of the patients was 5.1±1.7 (range 2.5-8) years. patients were followed for 25.6±5.2 (range 18-35) months. there was no statistically significant difference between the two groups in term of bcva. visual axis remained clear in all cases of both groups. early postoperative fibrin formation was seen in two eyes of each group. there was no significant iol decentration in any cases. conclusion: posterior capsulotomy followed by anterior vitrectomy and implantation of hydrophobic acrylic iol in pediatric cataract surgery significantly decreases secondary opacification of visual axis. in the cases with difficult or impossible implantation of iol in the capsular bag, implantation of haptics in ciliary sulcus and iol optic capture through posterior capsulorrhexis is a safe alternative method.