Primary posterior capsulorhexis with optic capture and intracameral heparin in paediatric cataract surgery

Purpose: To study the efficacy of using a primary posterior capsulorhexis with optic capture and intracameral heparin in preventing secondary posterior capsule opacification, in paediatric cataract surgery. Methods: Primary posterior capsulorhexis and optic capture with a heparin-coated in traocular lens (IOL) was performed after lens aspiration in 14 cataractous eyes of 13 children (group I),Ten international units of heparin were added in the irrigating solution. The results were compared with 14 eyes of I I children who underwent a similar surgical procedure but without a posterior capsulorhexis (group 2). Results: The mean age of the patients in group I was 4.2 +/- 1.5 years (mean +/- SD) and in group 2 was 4.5 +/- 1.8 years (range 3-6 years in both the groups). The mean duration of follow up was 36+/-6.4 months in group I and 38 +/- 8.1 months in group 2. A best corrected visual acuity of 6/24 or better was achieved in 12 eyes in group I and II eyes in group 2. The visual axis remained clear in all the eyes in group I,while 8 eyes (57.14%) in group 2 developed posterior capsule opacification (P=0.0034) which required a neodymium:yttrium-aluminum-garnet laser capsulotomy. Conclusions: Lens aspiration using intracameral heparin, combined with primary posterior capsulorhexis and optic capture of a heparin-coated IOL, is a useful technique to prevent secondary visual axis opacification in paediatric cataracts.