Journal of Clinical and Experimental Ophthalmology
Open Access

Abstract

LARV: Limbal Approach Retropseudophakic Vitrectorrhexis and Vitrectomy - An Innovative Technique for the Management of Pediatric Cataract

Kothari Mihir, Manurung Florence, Shukri Najeeha and Paralkar Shalaka

Aim: To report safety and efficacy of LARV (Limbal Approach Retropseudophakic Vitrectorrhexis and Vitrectomy), an innovative technique for the management of Pediatric Cataract. Subjects and Methods: This descriptive caseseries included children undergoing IOL implantation with primary posterior capsulectomy and anterior vitrectomy for developmental or traumatic cataract with no other ocular co-morbidity. All the patients had hydrophobic IOL implanted in the bag followed by LARV performed by a pediatric ophthalmologist in the learning phase of this technique. On follow up, the patients were evaluated for 1) IOL position, 2) size and centration of the posterior capsulectomy, 3) adequacy of anterior vitrectomy and 4) complications. Results: 23 eyes of 18 consecutive patients, aged 4.5 ± 3.5 years with a mean follow up of 7.3 ± 4 months were included. 3 had traumatic cataract, 20 had developmental cataract and 13 were females. Ninety one % (21/23) had IOL in the bag, mean posterior capsulectomy size was 4.6 ± 0.9 mm, IOL was well centered and anterior vitrectomy was adequate in all. During the surgery, one patient had partial dislocation of the IOL behind the posterior capsule that needed IOL repositioning in the sulcus. One patient had one haptic in the anterior chamber that needed repositioning. Three patients had posterior synechia < 1 clock hour, 4 had pigmentation on the IOL optic. Conclusion: LARV is a useful technique for pediatric cataract albeit with a steep learning curve. Potential complications of LARV during the learning phase need awareness. A case–control study is needed to assess its advantages over conventional technique of pediatric cataract surgery.