Congenital Cataract with Pre-existing Posterior Capsule Defect

To evaluate the diagnostic signs, intraoperative complications and postoperative outcomes in children with congenital cataract and pre-existing posterior capsule defect (PPCD). This interventional case series was conducted on 14 eyes of 7 patients who underwent lensectomy-anterior vitrectomy for congenital cataract with PPCD. All children had bilateral cataract. Preoperative diagnostic signs of PPCD detected under maximum pupil dilation in patients without a mature cataract included a well-demarcated horizontal oval defect with white margin and scattered white dots around the defect. The greatest lens opacity was over the defect itself. In patients with mature cataract, PPCD was diagnosed during operation. Bimanual irrigation/aspiration and 2-port anterior vitrectomy was performed in all cases. The patients included in 2 girls and 5 boys with mean age of 11.44.1 months. PPCD was diagnosed preoperatively in 5 patients (10 eyes) and intraoperatively in 2 patients (4 eyes). Intraocular lens was implanted in 2 eyes of one patient and 12 eyes were left aphakic. Except for nucleus dislocation into the anterior vitreous in our first case which was successfully removed, no other intraoperative complication occurred. During a mean follow up of 21.17.1 months (18-36 months) the visual axis remained clear in all the eyes. Establishing the diagnosis of PPCD preoperatively with fully dilated pupil and careful surgical planning prevents intraoperative complications and produces satisfactory technical results.