gms | German Medical Science

Purpose: To develop a technique for pediatric cataract removal reducing traumaticity and time of operation using aspiration only without irrigation.

Methods: Viscoelastic injected into the anterior chamber is a lid closing lens material in capsulorhexis zone. Under this lid it becomes possible to perform aspiration of lens material quickly and safely without irrigation. Aspiration starts from the equatorial zone of the lens with a cannula inserted through the main tunnel incision. In one pass lens material is aspirated along the entire equator with circular motion of the cannula. Only at the final step lens material is aspirated from the central zone of the lens. At this moment the distal end of the cannula is placed at the equator, sliding upon the posterior capsule with aspiration hole upwards. During all the steps of operation viscoelastic should be prevented from aspiration into the cannula. It is possible due to use of transparent polymer cannula and visual control by the surgeon. The technique of operation is as follows. Corneal tunnel incision 1.0–2.2 mm long is performed; CCC 5.0–5.5 mm in diameter is performed with a collet forceps. Removal of lens material is performed as described. An IOL is implanted into the capsular bag if axial length is over 21 mm.

Results: In our clinic 92 operations have been performed in children aged from 3 months to 16 years. All the operations were uneventful. Operation time was reduced due to shorter step of aspiration.

Conclusions: The suggested technology results in reduction of operation trauma and surgery time, quicker rehabilitation of the patients. The technology may be successfully used in congenital lens ectopia, i.e. Marfan’s syndrome, microspherophakia, where weak Zinn’s zonulae are present and leaking of irrigation fluid into the retrolental space is possible.