Overcoming Pediatric Challenges

1. Manish Mahendra
2. Youraj Mahendra
3. Shally Mahendra

Khairabad Eye Hospital,Kanpur,India

PURPOSE: To demonstrate an effective technique to handle postoperative occlusio pupillae after cataract surgery and removal of the underlying posterior capsular plaque.

METHODS:A case report of a 7 year old boy who had undergone cataract surgery elsewhere followed by development of occlusio pupillae. Central iris tissue covered over and adherent to the PCIOL was dissected and removed using vitreoretinal scissors and forcep.Pupilloplasty was performed.Iris retractors were used to stretch the pupil and view the underlying posterior capsular plaque.Removal of the underlying posterior plaque behind the IOL was done with the help of modified cystitome and vitreoretinal scissors through the opening of previous iridectomy.This was followed by anterior vitrectomy and removal of viscoelastics.

RESULTS: The surgical technique resulted in a clear central visual axis.With appropriate postoperative management and control of inflammation by steroids;increased visual acuity was observed postoperatively.

CONCLUSIONS: Difficult situations can be tackled by meticulous surgical approach and effective postoperative management