Large vs. small posterior capsulotomy size and visual angle opacification rates
Reviewed by Fiona Rowe

The purpose of this study was to assess the relationship between posterior capsulotomy size and significant visual angle opacification (VAO) in congenital and developmental cataract. This was a retrospective case control of children aged under seven years of age over a 10-year period and include 60 eyes of 41 children. Group 1 were surgery with conventional methods in which the posterior capsulotomy size was smaller than the anterior capsule size. Group 2 involved a novel method where the posterior capsulotomy was larger than the anterior capsule size. Group 1 comprised eight females, 11 males and with median age at surgery of five-point-five years. Group 2 comprised eight females, 11 males and median age at surgery of three years. Primary intraocular lens implant was in 85.2% of group 1 and 75.8% of group 2. There were no significant differences between groups for pre- and post-logMAR visual acuity, refractive error, follow-up period or complications of surgery. A second procedure was needed for 44.4% in group 1 and 3% in group 2. The rate of secondary VAO requiring treatment was low in group 2. The authors acknowledge their retrospective study design as a limitation. They suggest their results are promising in terms of performing larger primary posterior capsulotomy in reducing the need for further treatment for significant VAO. However, this requires further and larger prospective trials.

Posterior capsulotomy size affects the formation of significant visual axis opacification on congenital and developmental cataract.
Yucel OE, Gul A.
JOURNAL OF PEDIATRIC OPHTHALMOLOGY AND STRABISMUS
2023;60:441–7.