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Study: PCO highly likely in children under age 4 after small-incision acrylic lens implantation

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DALLAS — The incidence of posterior capsular opacification following small-incision foldable acrylic lens implantation in children older than age 4 is lower than those rates reported by conventional large-incision rigid lens techniques, even with a minimum of 2 years’ follow-up, said David R. Stager Jr., MD, and colleagues. Opacification appears inevitable, however, in children younger than age 4 who undergo this procedure, Dr. Stager added.

Twenty-six eyes of 18 patients underwent small-incision cataract extraction with posterior chamber foldable acrylic lens implantation; the posterior capsule was left intact in all patients. The AcrySof MA30BA lens (Alcon) with a 5.5 mm acrylic optic, 12.5 mm overall length and PMMA haptics was used in all patients. Follow-up ranged from 24 to 48 months; age of the children at time of surgery ranged from 21 months to 14 years.

In the five eyes of children under age 4, all eyes developed clinically significant posterior capsular opacification (PCO) at a mean follow-up of 8 months. Subsequent surgery via Nd:YAG laser capsulotomy to clear the visual axis was performed on all five eyes. Two eyes have maintained a clear visual axis with a mean follow-up of 32 months, but three eyes developed recurrent opacification at 33 months’ postop, according to the study.

In children older than age 4, eight of 21 capsules opacified at a mean of 14 months. One eye underwent pars plana posterior capsulectomy with anterior vitrectomy 6 months after surgery; seven eyes underwent Nd:YAG laser capsulotomy. Six of those eyes have maintained a clear visual axis with a mean follow-up of 13 months, the study indicated.

The study is published in the March/April issue of Journal of Pediatric Ophthalmology & Strabismus.