Original Research Article DOI: 10.18231/2395-1451.2019.0024 Indian Journal of Clinical and Experimental Ophthalmology, January-March, 2019;5(1):105-107 105 Comparative evaluation of posterior capsular opacification and Nd: YAG capsulotomy in children and adults Tarannum Shakeel 1 , Sushobhan Das Gupta 2,* 1,2 Associate Professor, Dept. of Ophthalmology, Shri Guru Ram Rai Institute of Medical & Health Sciences, Dehradun, Uttarakhand, India *Corresponding Author: Sushobhan Das Gupta Email: dr_sushobhan@yahoo.co.in Abstract Objective: To compare the rate of posterior capsular opacification and Nd:YAG laser capsulotomy in children and adults after cataract surgery and primary intraocular lens implantation. Materials and Methods: 38 eyes of 24 children and 53 eyes of 47 adults patients who had undergone phacoaspiration/phacoemulsification surgery with primary in the bag posterior chamber intraocular lens (PCIOL) implantation were included in the study. A retrospective analysis of data was performed. The rate of posterior capsular opacification (PCO) and Nd:YAG laser capsulotomy was compared between children and adults with different type of intraocular lenses (PMMA and acrylic). Results: Age of the children ranged from 2 to 12 years and that of the adults from 47 to 80 years. PCO developed in 27.28% eyes of children with Acrylic intraocular lens (IOL) and in 75% eyes with square edge PMMA lens. PCO did not develop in any of the adult patients with either PMMA or acrylic IOL. Conclusion: Rate of PCO in children is lower with acrylic IOL as compared to square edge PMMA lens. However in adults, PCO preventing effect of IOL material seems to be immaterial in the hands of an experienced phaco surgeon. Keywords: Acrylic, Intraocular lens, Posterior capsular opacification, PMMA. Introduction Posterior capsular opacificaiton is the most frequent complication of cataract surgery and is known to compromise vision and increase ocular morbidity. Advances in surgical techniques and IOL material have reduced the PCO rate; however it remains a significant problem resulting in suboptimal outcome of cataract surgery. IOL implantation in children is associated with higher perioperative complications and an increased risk of subsequent posterior capsular opacification as compared to audlts. 1 Foldable soft acrylic IOLs have lower PCO rates than polymethylmethacrylate (PMMA) lenses in adult eyes. 2,3 There is increasing evidence of PCO reduction with newer IOL designs and materials. 4,5 Since the incidence of PCO is very high in paediatric patients and the long term effect of the anterior vitrectomy and Nd:YAG laser capsulotomy in this group is not known, use of an IOL to inhibit PCO formation is highly desirable. In the present study we evaluated the performance of PMMA and acrylic IOL in the development of PCO in a group of paediatric patients and compared the results with the adult patients. Materials and Methods 38 eyes of 24 children and 53 eyes of 47 adult patients who underwent cataract surgery in a tertiary care hospital in Uttarakhand were included in the study. Due permission was obtained from the institutional ethical review board. Retrospective analysis of data was performed. The inclusion criteria for the children included patients operated for unilateral or bilateral congenital or developmental cataract. The adults operated for any type of uncomplicated senile cataract with primary IO L implantation were included in the study. Patients with associated ocular disease (microphthalmos, microcornea, glaucoma, uveitis, traumatic or complicated cataract, posterior lenticonus, coloboma), systemic disease, patients with any intraoperative complications, children in whom posterior capsulotomy with anterior vitrectomy was done and patients with secondary IOL implantation were excluded from the study. All the patients were subjected to a detailed preoperative evaluation. The visual acuity was recorded with Snellen’s visual acuity chart or the illiterate E chart. Fixation pattern was noted in uncooperative patients. Slit lamp biomicroscopy was done. Intraocular pressure (IOP) was measured in most patients using Goldmann Applanation tonometer or the Perkin’s Hand held tonometer. Preoperative keratometry was done and axial length (AL) was measured. In some children AL and keratometry was done on the table under GA, preoperatively. SRK –II formula was used for IOL power calculation, using IOL Master A scan machine. The IOL power was selected to ensure postoperative emmetropia. All the patients in both groups underwent clear corneal phacoemulsification/ phacoaspiration with in the bag posterior chamber IOL by a single surgeon, utilizing standard surgical technique. Alcon centurion phacosystem was used in all cases. A gap of at least one month was kept before operating the other eye in cases of bilateral cataract. Thorough hydrodissection during surgery and complete removal of the cortical matter was ensured in all the cases. The posterior capsule was left intact in all the cases. Either a 5.5 mm foldable acrylic IOL (MA30BA) or after extending the tunnel, a 5mm all PMMA IOL (IAB203) was implanted in the bag. The viscoelastic was aspirated thoroughly. Postoperatively, all patients received standard regimen of steroid antibiotic drops in biweekly tapering doses. Patients were examined on the first postoperative day and subsequently at two weeks, one month, 3 months and 6