Diagnosis and management of congenital cataract with preexisting posterior capsule defect

Abstract

Establishing the diagnostic signs of PCD with the eye fully dilated and carefully planning the surgery produced satisfactory technical and visual outcomes.

Preexisting posterior capsule defect progressing to white mature cataract

“…This condition manifests itself among infants and small children as a congenital cataract with an existing defect in the posterior capsule. 1 Diagnostic signs of preexisting posterior capsule defect have been described in the literature as the presence of a characteristic demarcation of thickened margins on the posterior capsule defect, white dots on the defect and anterior vitreous face, and the pathognomonic sign of the "fish tail." 1 The fish tail sign is observed when the globe is moved with a forceps: the anterior vitreous opacities move within the semi-liquefied vitreous in a manner suggestive of a moving fish tail.…”

Single-piece AcrySof intraocular lens implantation in children with congenital and developmental cataract

“…The AcrySof IOL results in a lower visual axis obscuration rate and is biocompatible with pediatric eyes. [10][11][12][13][14][15][16][19][20][21][22][23][24] In a worldwide survey conducted in 2001, 66.8% of American Society of Cataract and Refractive Surgery respondents and 71.7% of American Association for Pediatric Ophthalmology and Strabismus respondents preferred hydrophobic acrylic IOLs for children. 3 The results of 3-piece AcrySof IOLs are favorable.…”

“…Multiquadrant hydrodissection was performed in all cases except in eyes with white mature cataract or when a preexisting posterior capsule defect was suspected. [22][23][24][25] The lens material was aspirated using bimanual irrigation/aspiration (I/A). A posterior continuous curvilinear capsulorhexis (PCCC) was made in children younger than 6 years (Group 1, 66 eyes) and not in children 6 years and older (Group 2, 68 eyes).…”

Surgical approaches to posterior polar cataract: a review

“…In our case series of 400 eyes that underwent cataract surgery for congenital cataract, a defect was present in 27 eyes (7%). 41 The preoperative diagnostic signs of a pre-existing posterior capsule defect in children include a well-demarcated defect with thick margins, chalky white spots in a cluster or a rough circle on the posterior capsule, and white dots in the anterior vitreous that move with the degenerated vitreous like a fish tail sign ( Figure 13). [41][42][43][44][45] The surgical paradigms for cataract surgery in eyes of children with PPC remain essentially similar to those used in adult eyes.…”

“…[41][42][43][44][45] The surgical paradigms for cataract surgery in eyes of children with PPC remain essentially similar to those used in adult eyes. 41 The authors prefer to adopt the closed chamber technique. The anterior chamber is first entered using a paracentesis incision.…”