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    Bilateral cataract surgery in adult and pediatric patients in a single session
    (Elsevier Science Inc, 2000) Totan, Y; Bayramlar, H; Çekiç, O; Aydin, E; Erten, A; Daglioglu, MC
    Purpose: To evaluate the results of bilateral simultaneous cataract surgery in adult and pediatric patients under local or general anesthesia. Setting: Department of Ophthalmology, Inonu University, Turgut Ozal Medical Center, Malatya, Turkey. Methods: Eighty-two eyes of 41 patients were included in the study. Twelve of 17 pediatric patients with congenital cataract had bilateral simultaneous lensectomy, posterior capsulotomy, and anterior vitrectomy; 5 patients, aged 10 to 19 years, had bilateral extracapsular cataract extraction (ECCE) with posterior chamber intraocular lens (PC IOL) implantation. Forty-eight eyes of 24 adult patients had bilateral simultaneous ECCE with primary (43 eyes) or secondary (5 eyes) PC IOL implantation. Local anesthesia was administered to 20 adult patients by retrobulbar injection; the other cases were performed using general anesthesia. The procedures were treated as 2 separate surgeries in the same session; care was taken to ensure surgical asepsis. Results: No serious intraoperative complications occurred such as posterior capsule rupture, vitreous loss, endophthalmitis, and anesthesia-related problems. Of patients tested, 84.4% achieved a final best corrected visual acuity of 6/12 or better and 31.0%, of 6/6 or better. Conclusions: Simultaneous bilateral cataract surgery was not associated with an increased rate of complications, and visual results were good. If strict rules of surgical asepsis are followed, this may be a useful option in a variety of bilateral cases using general or local anesthesia. J Cataracr Refract Surg 2000; 26:1008-1011 (C) 2000 ASCRS and ESCRS.
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    Retrospective comparison of surgical techniques to prevent secondary opacification in pediatric cataracts
    (Slack Inc, 2000) Er, H; Doganay, S; Evereklioglu, C; Erten, A; Cumurcu, T; Bayramlar, H
    Purpose: To evaluate the effect of different surgical methods for management of the posterior capsule and anterior vitreous on the rate of posterior capsule opacification in pediatric cataracts. Methods: Charts of 34 children (47 eyes) aged 40 days to 18 years (mean: 8.5 years) who had primary cataract surgery with or without posterior chamber intraocular lens (IOL) implantation during the past 5 years were reviewed. In 26 eyes, cataracts were managed with a posterior continuous curvilinear capsulorhexis, and in 21 eyes, the posterior capsule was left intact. Follow-up averaged 10 months (range: 6.5 months to 5 years). Results: Visually significant secondary cataract developed in nine eyes with intact posterior capsules, and seven eyes required Nd:YAG laser posterior capsulotomy. The average time for YAC capsulotomy postcataract removal in the second group was 4 months. The visual axis remained clear in all eyes that had posterior continuous curvilinear capsulorhexis with or without posterior chamber IOL. Complications such as fibrinoid membrane, stromal edema, posterior synechiae, updrawn pupil, and transient glaucoma occurred in both groups at a similar rate. Conclusion: Primary posterior continuous curvilinear capsulorhexis is an effective method for preventing secondary cataract formation in pediatric cataracts.