Vitrectomy techniques in Paediatric Cataract Surgery Dr.Ajay I.Dudani Zen Eye Center Surya Eye Tech.

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Vitrectomy techniques in Paediatric Cataract Surgery Dr.Ajay I.Dudani Zen Eye Center Surya Eye Tech.

Immediate Imminent PCO is the bug bear of Pead.Catatact Surgery. This can lead to irreversible amblyopia. Post.Capsule & Ant.Vitreous Phase are the scaffold for proliferation of LES Hence the Rationale of primary PCCC with ant.Vit. With optic capture

Approaches for Ant.Vit. Ant. Approach from limbal side port. Pars Plana approach 3mm post to limbus.

Pathogenesis The term PCO is misleading. A-cells : fibrousmetaplasia fibrous PCO E-cells : mitosis PCO with ‘pearls’

Other cells involved in formation of PCO Infammatory cells –WBCs RBCs Collagen deposition Iris melanocytes

Anterior capsule opacification [ACO] in extreme cases results in capsule contraction syndrome[CCS]..

Interlenticular opacification Soemmerring’s ring

Ant. Vitrectomy approach - Vitrector Technique of Paediatric Cataract G/A With ketamine with Local Lignocane Block Scleral Tunnel CCC With needle / Vitreous cutter Hydrodissection AC Maintainer inserted. IA Done with Vitreous cutter from side port.

Vitrector Technique of Paediatric Cataract IOL inserted in the bag. Post. CCC with Generous Ant. Vitrectomy from side port with cutter. Wound and side port hydration

Video

Automated I/A Technique Scleral Tunnel CCC Hydro-dissection Automated I/A (irrigation/aspiration) through side ports. IOL Inserted Ant.Vit.+ PCC from side port.

Post. Pars Plana Approach 3mm from limbus 2port Infusion- bent 20G needle Direct clean anatomical approach for generous ant. Vit. PCCC done from behind Less chance of vit.Prolapse in AC.

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