Application of minimally invasive 23G vitrectomy via corneal approach for the treatment of pediatric cataract.

OBJECTIVES To determine the curative effect and complications of 23G vitrectomy via corneal approach for the treatment of pediatric cataract. MATERIALS AND METHODS We performed anterior circular capsulotomy, lentectomy and aspiration, posterior circular capsulotomy, and anterior vitrectomy via corneal approach in 40 eyes from 25 children with congenital cataract. In patients aged > 2 years, foldable intraocular lens (IOL) was implanted and frame glasses were prescribed at younger age. The intraoperative/postoperative complications, comfort level, and inflammatory reaction after surgery were observed. RESULTS No intraoperative complications occurred and 9 eyes were simultaneously implanted IOL. All patients could blink normally except one child who suffered from corneal epithelial abrasion for one day. All corneas were clear and only mild postoperative inflammation was observed. There was no hyphema, effusion, hypotony, and hypertension. A week later, the mild congestion also disappeared. All parents reported good vision of their babies allowing them free play during 3-50 months follow-up. This surgical technique provided a clear 4-6 mm diameter visual axis and circular pupil in all cases. The IOL positions were centered at the pupil area. No secondary cataract developed. CONCLUSIONS The 23-gauge vitrectomy via corneal approach for the treatment of pediatric cataract involves only mild discomfort and fewer complications.