Posterior capsule opacification in children: comparison of posterior continuous curvilinear capsulorhexis alone and pars plana posterior capsulectomy with anterior vitrectomy

Orazbekov L. Ruslanuly K. Kurakbay A. Zhurgumbayeva G. Bakhytbek R.
December 2025 Elsevier Inc.

Journal of AAPOS
2025 #29 Issue 6

Purpose: To compare the incidence, timing, and visual outcomes of posterior capsule opacification (PCO) following pediatric cataract surgery comprising either posterior continuous curvilinear capsulorhexis without anterior vitrectomy (PCCC−) or pars plana posterior capsulectomy with anterior vitrectomy (PPPC+). Methods: The medical records of pediatric patients undergoing surgery for congenital cataract at a single tertiary care facility from January 2013 to December 2022 were reviewed retrospectively. All eyes underwent primary intraocular lens implantation at the time of cataract surgery. A total of 643 eyes underwent PCCC− and 628 underwent PPPC+. Outcomes included PCO incidence, age at diagnosis, time to development, and best-corrected visual acuity (BCVA). Results: PCO incidence was significantly higher in the PCCC− group than in the PPPC+ group (144 [22.4%] vs 62 [9.9%] P < 0.001). Patients who developed PCO underwent initial cataract surgery at a mean age of 2.73 ± 2.04 years in the PCCC− group and 2.03 ± 1.63 years the PPPC+ group (P = 0.02). Age at PCO diagnosis was 3.87 ± 1.92 years in the PCCC− group and 5.28 ± 2.83 years in the PPPC+ group (P = 0.001). Time to PCO development was 1.84 ± 1.13 years in the PCCC− group and 2.56 ± 1.56 years in the PPPC+ group (P = 0.003). Of the 206 patients who developed PCO, 121 patients (58.7%) were cooperative for optotype testing. Preoperative BCVA was similar between groups (1.72 ± 0.59 and 1.68 ± 0.46 logMAR for PPPC− and PCCC+, resp. [P = 0.865]); postoperative BCVA improved significantly within each group (P < 0.001), with no intergroup difference (0.88 ± 0.40 and 0.93 ± 0.46 logMAR for PPPC− and PCCC+, resp. [P = 0.612]). The other 85 noncooperative children (41.3%) showed postoperative improvement in ability to fix and follow objects in both the PCCC− group and the PPPC+ group (9.6% to 92.3% and 6.1% to 90.9% [both P < 0.001]). Conclusions: Combined capsulectomy and anterior vitrectomy markedly reduces and delays PCO compared to PCCC alone, with equivalent visual gains.

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First Ophthalmology Department, Kazakh Eye Research Institute, Almaty, Kazakhstan
Science Management Department, Kazakh Eye Research Institute, Almaty, Kazakhstan
Second Ophthalmology Department, Kazakh Eye Research Institute, Almaty, Kazakhstan

First Ophthalmology Department
Science Management Department
Second Ophthalmology Department

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