Thesis (Ph.D.) - Cairo University - Faculty of Medicine - Department of Ophthalmology

Objective: This study aimed at comparing between posterior capsulotomy and anterior vitrectomy for cases of pediatric congenital cataract surgery with primary IOL implantation through the limbal approach versus the pars plicata approach. Design: Prospective randomized comparative interventional study. Methods: 57 eyes of children from 1 to 5 y old who have congenital cataract that is indicated for irrigation /aspiration (I/A) and primary IOL implantation were included and randomly divided into Group A (28 eyes) (the limbal approach) and Group B (29 eyes) (the pars plicata approach). Hand held SD- OCT examinations were done for all eyes at 2 weeks, 6 weeks, 3 months and 6 months postoperatively. It was also done on 180 eyes of normal children {u02C2} 5 y old to be used as a control group. Comparison was done between the two surgical techniques with FU period of 6 months Results: Incidence of intraoperative complications was much higher in Group A than Group B (P value = 0.002). Most of early and late postoperative complications occurred more frequently in Group A than Group B .100% and 53.6% of eyes in Group B and A respectively had stable IOL in bag (P value < 0.001). The CFT in Group B was significantly higher than Group A at 1st, 2nd and 3rd FU visits. (P value 0.015, 0.015 and 0.027 respectively). The CST of Group B was significantly higher than CST of normal controls in all FU visits. (P value 0.016, 0.006, 0.024, 0.041 respectively). However, there were no cases with macular edema or any other macular changes through the follow up period in both groups

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