ABSTRACT
PURPOSE: To describe the diagnostic signs and biometric characteristics of preexisting posterior capsule defects in congenital cataract. SETTING: Eye Hospital of Wenzhou Medical University, Wenzhou, Zhejiang, China. DESIGN: Retrospective case series. METHODS: Eyes with congenital cataract were reviewed and divided into a preexisting posterior capsule defect group (study group) and a control group with intact posterior capsules. Diagnostic signs were summarized on agreement of 3 ophthalmologists after they reviewed surgical videos. The biometric parameters, including central corneal thickness, anterior chamber depth, lens thickness, vitreous chamber depth, axial length, mean keratometry, corneal astigmatism, corneal diameter, and intraocular pressure, were compared between groups. The predictors of preexisting posterior capsule defect were determined using univariate and multivariate analyses. RESULTS: The study comprised 81 eyes (53 patients). The diagnostic signs of preexisting posterior capsule defect included posterior capsule plaque with a well-demarcated margin, gray granules and vacuoles, and heterogeneous nuclear opacity (more dense in the posterior). The lens was significantly thinner in the study group than in the control group (P < .001). The corneal diameter was significantly smaller in the study group (P = .015 horizontal and P = .005 vertical). Multivariate analysis identified lens thickness as an independent predictor (odds ratio, 0.731; 95% confidence interval, 0.621-0.860; P < .001). CONCLUSIONS: For preexisting posterior capsule defect, lens thickness was a valuable predictor and the presence of characteristic morphology was an important indicator. The cornea configuration suggests the need for further study of the role of genetic mutation.
Subject(s)
Cataract/congenital , Eye Abnormalities/diagnosis , Lens Diseases/diagnosis , Posterior Capsule of the Lens/abnormalities , Anterior Chamber/pathology , Astigmatism/diagnosis , Biometry , Cataract Extraction , Female , Humans , Infant , Intraocular Pressure/physiology , Lens, Crystalline/pathology , Male , Organ Size , Posterior Capsule of the Lens/pathology , Retrospective Studies , VitrectomyABSTRACT
An 8-year-old girl with unilateral posterior lenticoglobus underwent lens aspiration and intraocular lens implantation. Wavefront analysis performed before surgery to assess the surgical indication showed a higher-order aberration of 0.502 µm root mean square. After surgery, the value decreased to 0.132 µm root mean square. Preoperative best-corrected visual acuity of 0.1 improved to 0.3 postoperatively. Electron-microscopic examinations of the posterior capsule revealed unusual nodular structures and variations in capsular density.
Subject(s)
Cataract Extraction , Cataract/pathology , Lens Implantation, Intraocular , Posterior Capsule of the Lens/abnormalities , Posterior Capsule of the Lens/ultrastructure , Aberrometry , Child , Female , Humans , Lens, Crystalline/abnormalities , Microscopy, Electron, Transmission , Visual AcuityABSTRACT
Posterior capsules of pediatric eyes with lens disorders have complex morphological variations with differing etiologies and visual prognoses. We describe a unique case of intraoperative posterior capsule flutter in an eye of a child undergoing cataract surgery, which we interpret as a possible expression of posterior lentiglobus.
