الفهرس 
IntroductionOnly 14 pages are availabe for public view
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Abstract
Improvements in techniques, technology, and surgeons’ understanding of pediatric cataract management have led to better technical and functional outcomes. Despite this, visual axis obscuration (VAO) remains as one of the major obstacles that hamper visual rehabilitation, might induce amblyopia, and necessitate additional surgical procedures when using general anesthesia. The incidence of PCO after cataract surgery is nearly 100% in small children and is a significant cause of amblyopia. Visual axis obscuration has been reported to be more frequent and severe when cataract surgery is performed at a younger age. Therefore, constant efforts are being made by pediatric cataract surgeons to reduce or delay the onset of VAO, in particular in younger children. Various approaches have been suggested to prevent PCO. One is capturing the IOL optic through the posterior capsule opening while the haptics remain in the bag (posterior capsulorhexis with optic capture). However, whether to perform anterior vitrectomy with the previous technique is still a matter of debate. The current study was conducted at Mansoura University Ophthalmology Center aiming to compare the postoperative outcomes between the optic capture technique with the standard in the bag IOL implantation in pediatric undergoing congenital cataract surgery. Also, we evaluated whether optic capture technique would decrease the need for anterior vitrectomy in such cases. We included a total of 60 eyes with congenital cataract. All patients were subjected to history taking, ophthalmological examination, and ocular ultrasound. After signing a written consent by the parents, they were randomly assigned into three groups (vis the sealed envelope method), group I (included 20 eyes who underwent anterior capsulorhexis, aspiration of cataract, posterior capsulorhexis, anterior vitrectomy, and in the bag IOL implantation), group II (included 20 eyes who underwent the same steps as group I but with IOL implantation via the optic capture technique), and group III (included the remaining 20 eyes who underwent the same as group II but anterior vitrectomy was omitted). After the operation, patients were followed up for one year. During these visits, clinical assessment was done, and IOP was measured. Any postoperative complication was noticed and recorded. Regarding the operative time there was statistically significant prolongation in group (II), followed by group I while group III had the shortest operative time. group (II) had the largest mean clear zone while group (I) had the smallest clear zone. Regarding the complications; no major intraoperative complications were detected. The incidence of postoperative complications was statistically comparable among the three study groups with no post cataract surgery glaucoma was detected. No statistically significant relationship was noted in this study between visual axis opacification and patients age. Conclusion : The posterior optic capture technique in pediatric cataract surgery is considered an appealing alternative option to the in the-bag IOL implantation with anterior vitrectomy technique. It has the ability to prevent PCO occurrence eliminating the need for anterior vitrectomy. Optic capture technique favors less uveal inflammatory sequelae in pediatric eyes which -by nature- are more prone to the inflammatory response than adult population due immaturity of the blood-aqueous barrier. To sum up; the two methods may be statistically equal in maintain the long term visual axis clarity but posterior optic capture technique may eliminate the need for anterior vitrectomy with its drawbacks.