Cataract, Juvenile
Conditions
Keywords
cataract surgery; intraocular lens; optic capture; pediatric cataract; posterior capsulotomy
Brief summary
Purpose: To compare two pediatric cataract surgery procedures: intraocular lens (IOL) optic capture without anterior vitrectomy (AV) and in-the-bag IOL implantation with AV. Setting: Ege University Medical School Hospital, Izmir, Turkey. Design: Prospective randomized control clinical trial. Methods: Patients were randomly assigned to two groups: optic capture without AV (Group 1) or in-the-bag implantation with AV (Group 2). The following variables were compared: visual acuity, intraocular pressure, refractive errors, IOL tilt and decentration, lenticular astigmatism, anterior-posterior synechia, inflammatory cell deposits on IOL and post-operative complications.
Interventions
PROCEDUREoptic capture
optic capture of Intraocular lens without anterior vitrectomy
PROCEDUREIn-the-bag implantation of Intraocular lens
in-the-bag implantation of Intraocular lens with anterior vitrectomy
Sponsors
Ege University
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
TREATMENT
Masking
NONE
Eligibility
Sex/Gender
ALL
Age
1 Years to 10 Years
Healthy volunteers
No
Inclusion criteria
* Children with congenital or developmental cataracts who had cataract surgery and primary IOL implantation at a tertiary care referral institute were included.
Exclusion criteria
* Traumatic or uveitic cataract, corneal opacity, iris coloboma, microphthalmia, microcornea, persistent fetal vascularization, congenital glaucoma, and retinopathy of prematurity were all considered
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Prediction error | at the post-operative one-month | Refraction prediction error (PE) was found by subtracting the early post-operative refraction from the pre-operative target refraction. |
| The prevalence of inflammatory deposits on Intraocular lens surface | through study completion, an average of 2 years | Eyes were evaluated presence of inflammatory deposits between the margins of capsulorhexis at the slit lamp examinations. |
| The prevalence of anterior-posterior synechia | through study completion, an average of 2 years | Eyes were evaluated for presence of anterior-posterior synechia at the slit lamp examinations. |
| Measurements of Intraocular lens tilt and decentration. | at the postoperative one-year | Measurement of Intraocular lens (IOL) position at vertical and horizontal meridians at the Scheimpflug images captured with corneal topography. Scheimpflug images were obtained (Pentacam HR, Oculus Optikgerate Gmbh, Wetzlar, Germany) at one postoperative year. The horizontal and vertical meridians' photographs were analyzed.These images were processed in AutoCAD LT 2020 2D CAD software for IOL position assessment.(1) IOL Center: Two arches were drawn that fit perfectly on the anterior and posterior surfaces of the IOL. The points where these two arcs met were marked. Between these intersection points, a line was drawn. The midpoint of this line was accepted as the IOL center. (2) IOL Decentration: It was determined by measuring the distance (mm) from the IOL center point to the pupillary axis. (3) IOL Tilt: Angle (degree) between the IOL axis and the line passing through the iridocorneal angle. |
| The prevalence of visual axis opacification | through study completion, an average of 2 years | Eyes were evaluated for presence of visual axis opacification at the slit lamp examinations. |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Lenticular astigmatism | One-year postoperatively | Calculated by subtracting corneal astigmatism from manifest astigmatism. |
| Posterior segment complications | through study completion, an average of 2 years | In the fundoscopic examination, the patients were evaluated for possible posterior segment complications such as retinal detachment, cystoid macular edema, and intraocular hemorrhage. |
| Intraocular pressure | at the postoperative one year | Intraocular pressure was measured by Tonopen (Reichart Technologies, Depew, NY), Perkins handheld Mk2 tonometry (Haag-Streit, Koeniz, Switzerland) or Goldmann applanation tonometry (Haag Streit, Koeniz, Switzerland), considering the patient's age and compliance. |
Countries
Turkey (Türkiye)
Outcome results
None listed