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Samaresh Srivastava , DNB Vaishali Vasavada , MS Sajani K. Shah, DO, MS

Long term follow up of Impact of Cortico Cleaving Hydrodissection on Posterior Capsule Opacification (PCO) after paediatric cataract surgery. Samaresh Srivastava , DNB Vaishali Vasavada , MS Sajani K. Shah, DO, MS Rupal Trivedi , MD, MSCR* Abhay R. Vasavada , MS, FRCS (England)

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Samaresh Srivastava , DNB Vaishali Vasavada , MS Sajani K. Shah, DO, MS

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  1. Long term follow up of Impact of Cortico Cleaving Hydrodissection on Posterior Capsule Opacification (PCO) after paediatric cataract surgery SamareshSrivastava, DNB VaishaliVasavada, MS SajaniK. Shah, DO, MS RupalTrivedi, MD, MSCR* AbhayR. Vasavada, MS, FRCS (England) M.R. Praveen , DO Iladevi Cataract & IOL Research Centre, Ahmedabad, India * Storm Eye Institute, MUSC, USA The authors have no financial interest in this presentation

  2. Vasavada AR, Dholakia SA, RajSM et al. Effect of cortical cleaving hydrodissection on posterior capsule opacification in age-related nuclear cataracts. J Cataract Refract Surg; 2006; 32:145-150 In eyes with multiquadrant cortical cleaving hydrodissection, a significantly lower percentage of the area of central posterior capsule was involved in the development of PCO Vasavada AR, Trivedi RH, Apple DJ, et al. Randomized clinical trial of multiquadranthydrodissection in pediatric cataract surgery Am J Ophthalmol 2003; 84-88 Cortex removal was easier and faster after multiquadrant cortical cleaving hydrodissection.

  3. Aim To evaluate the impact of multiquadranthydrodissection on posterior capsule opacification (PCO) after pediatric cataract intraocular lens (IOL) implantation surgery Study Design and Population • Prospective, randomized, controlled trial • This study comprised 43 eyes of children undergoing pediatric cataract surgery with IOL implantation

  4. Materials and methods Randomization • Single surgeon, Standardized surgical procedure • PCCC < 2 years • PCCC + Vitrectomy - 2-6 years • Intact PC > 6 years • 3-piece AcrySofIOL implantation Hydrodissection n = 21 eyes No Hydrodissection n = 22 eyes

  5. Results P value <0.05 statistically significant

  6. Results Mean Survival Time from Cataract Surgery to Secondary Intervention P = 0.03

  7. (PCO) with hydrodissection (A), and without hydrodissection (B) in eyes with PCCC anterior vitrectomy. (PCO) with hydrodissection (A), and without hydrodissection (B) in eyes with PCCC

  8. Strengths : Longer follow-up Limitation : Smaller sample size Conclusion • Development of PCO between the two groups was not statistically significant • However, we report the trend towards decreasing incidence and delay in developing visually significant PCO

  9. Implications Despite of lack of statistical significance, we believe that it is clinically important and will recommend multiquadranthydrodissection during pediatric cataract surgery, unless contraindicated due to questionable posterior capsule integrity

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