The authors evaluated the performance of 25G vitrectomy systems in the management of congenital cataract in infants through two routes – anterior (transcorneal) and posterior (pars plana). This was a prospective randomised trial (RCT) of 24 eyes of 12 patients <1 year old with bilateral congenital cataract. The anterior route was used for one eye and the posterior route for the second eye in each patient. The mean age was 7.5 months (3-12). The authors outline the advantage of smaller instrument size and greater instrument flexibility such as intraoperative maintenance of anterior chamber depth and stability in all eyes despite high positive vitreous pressure and prevention of iris prolapse. Disadvantages were lower infusion rate and decreased aspiration rate warranting increased aspiration setting and occasional requirement for increased cut rate and vacuum. There were no complications for any case and all had clear visual axes at 12 months follow-up. There were no significant differences in refractive outcome for eyes.

Comparison of transcorneal and pars plana routes in pediatric cataract surgery in infants using a 25-Guage vitrectomy system.
Raina UK, Bhambhwani V, Gupta A, et al.
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Fiona Rowe (Prof)

Institute of Population Health, University of Liverpool, UK.

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