PDF(Pubmed)
Abstract：
OBJECTIVE: The efficacy of posterior optic capture (POC) in reducing posterior capsule opacification (PCO) in pediatric cataract is well recognized. The purpose of this paper was to identify the surgical challenges when attempting this technique and highlight the etiquettes to follow when performing this maneuver.
METHODS: Prospective observational noncomparative case series. Children diagnosed with congenital or developmental cataracts undergoing cataract surgery and primary IOL implantation with posterior optic capture (and no anterior vitrectomy) from June 2017 to April 2022 at a tertiary care referral institute were included. Records of all intraoperative findings and postoperative complications until the last follow-up were noted.
RESULTS: Posterior optic capture was attempted in 53 eyes of 49 children aged 2.4 ± 1.98 years. The mean follow-up of the patients was 16.5 ± 14.2 months (range 6 months-5 years). Successful POC could be performed in 46 eyes (86.8%). Two eyes developed posterior capsular opacification at the last follow-up. In eyes where POC could not be performed, five of these (83%) were children below 12 months of age with half of them having a preexisting posterior capsular defect.
CONCLUSIONS: Posterior optic capture is technically challenging with a steep learning curve that can be mastered over time. Adequate relative sizing of the anterior and posterior capsulorhexis is important. Caution is advised when using this technique in infants and in cases with posterior capsular defects.
METHODS: Prospective observational noncomparative case series. Children diagnosed with congenital or developmental cataracts undergoing cataract surgery and primary IOL implantation with posterior optic capture (and no anterior vitrectomy) from June 2017 to April 2022 at a tertiary care referral institute were included. Records of all intraoperative findings and postoperative complications until the last follow-up were noted.
RESULTS: Posterior optic capture was attempted in 53 eyes of 49 children aged 2.4 ± 1.98 years. The mean follow-up of the patients was 16.5 ± 14.2 months (range 6 months-5 years). Successful POC could be performed in 46 eyes (86.8%). Two eyes developed posterior capsular opacification at the last follow-up. In eyes where POC could not be performed, five of these (83%) were children below 12 months of age with half of them having a preexisting posterior capsular defect.
CONCLUSIONS: Posterior optic capture is technically challenging with a steep learning curve that can be mastered over time. Adequate relative sizing of the anterior and posterior capsulorhexis is important. Caution is advised when using this technique in infants and in cases with posterior capsular defects.
摘要：
目的：后视捕获（POC）在减少小儿白内障后囊混浊（PCO）方面的功效已得到广泛认可。本文的目的是确定尝试此技术时的手术挑战，并强调执行此操作时应遵循的礼节。
方法：前瞻性观察非比较病例系列。纳入了从2017年6月至2022年4月在三级护理转诊机构接受白内障手术和后视神经捕获的原发性IOL植入（没有前玻璃体切除术）诊断为先天性或发育性白内障的儿童。记录所有术中发现和术后并发症的记录，直至最后一次随访。
结果：在49名年龄为2.4±1.98岁的儿童的53只眼中尝试了后视神经捕获。患者的平均随访时间为16.5±14.2个月（6个月-5年）。成功的POC可以在46只眼中进行（86.8％）。最后一次随访时，两眼出现后囊混浊。在无法执行POC的眼睛中，其中5例(83%)为12个月以下的儿童,其中一半先前存在后囊缺损.
结论：后视光学捕获在技术上具有挑战性，可以随着时间的推移掌握陡峭的学习曲线。前后撕囊的适当相对尺寸是重要的。在婴儿和后囊缺损的情况下使用此技术时，建议谨慎。
方法：前瞻性观察非比较病例系列。纳入了从2017年6月至2022年4月在三级护理转诊机构接受白内障手术和后视神经捕获的原发性IOL植入（没有前玻璃体切除术）诊断为先天性或发育性白内障的儿童。记录所有术中发现和术后并发症的记录，直至最后一次随访。
结果：在49名年龄为2.4±1.98岁的儿童的53只眼中尝试了后视神经捕获。患者的平均随访时间为16.5±14.2个月（6个月-5年）。成功的POC可以在46只眼中进行（86.8％）。最后一次随访时，两眼出现后囊混浊。在无法执行POC的眼睛中，其中5例(83%)为12个月以下的儿童,其中一半先前存在后囊缺损.
结论：后视光学捕获在技术上具有挑战性，可以随着时间的推移掌握陡峭的学习曲线。前后撕囊的适当相对尺寸是重要的。在婴儿和后囊缺损的情况下使用此技术时，建议谨慎。
