Visual axis opacification: Methods of prevention
Ram et al . (J Cataract Refract Surg.2003;29(8):1579-84) reported that it is the management of the posterior capsule rather than IOL design and material that influences the incidence of PCO.
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3614664/
Dada et al . (Clin Experiment Ophthalmol. 2000;28(5):361-3) noted that lens aspiration using intracameral heparin, combined with primary posterior capsulorhexis and optic capture of a heparin-coated IOL, was a useful technique to prevent secondary VAO in pediatric cataracts.
Koch et al . (Trans Am Ophthalmol Soc. 1997;95:351-60) reported that posterior capsulorhexis with anterior vitrectomy was the only effective method of preventing or delaying secondary cataract formation in infants and children.
Dixit et al . (J Cataract Refract Surg. 2010;36(9):1494-1498) reported that pediatric eyes receiving intracameral triamcinolone intraoperatively had significantly less anterior segment inflammation and no visual axis obscuration after cataract surgery with IOL implantation.
Raina et al . (J Pediatr Ophthalmol Strabismus.2002;39(5):278-87) noted that PCCC with optic capture of PC IOL prevented secondary VAO even in the absence of vitrectomy.
Grieshaber et al . (J Cataract Refract Surg. 2005;31(5):886-94) reported that posterior capsulotomy with optic entrapment of IOL proved to be a safe and efficient surgical procedure for preventing PCO in children with congenital cataracts. They concluded that an intact anterior hyaloid does not induce capsule opacification in association with optic entrapment; therefore, a vitrectomy is not indicated even in infants and children under 5 years.
Chen et al . (Zhonghua Yan Ke Za Zhi. 2006;42(5):400-2) reported that optic capture of PC IOL is safe and effective in prevention of secondary opacification of the visual axis in children.
Tassignon et al . (J Cataract Refract Surg. 2007;33(4):611-7) concluded that bag-in-the-lens implantation technique in children is safe and keeps the visual axis clear after cataract surgery.
Onol et al . (Can J Ophthalmol.2008;43(6):673-7) reported that pars plana lensectomy with double-capsule-supported IOL implantation technique in children limits PCO in long term.
Management of visual axis opacification
Lam et al . (Clin Experiment Ophthalmol. 2005;33(5):495-8) reported that posterior capsulotomy using 25-G vitrectomy system is safe and effective in management of PCO in pseudophakic children. There is ease of manipulation with smaller instruments in these small eyes.
Xie et al . (J Pediatr Ophthalmol Strabismus2008;45(6):362-5) also noted that pars plana capsulectomy and vitrectomy is safe and effective in thick PCOs in pseudophakic children.
Stager et al . (JAAPOS 2006;10(2):159-63) reported that Nd:YAG laser capsulotomy is an acceptable option for the management of PCO after AcrySof IOL implantation in children and produces complications infrequently.
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