A FALSE SECONDARY CATARACT IN CHILDREN WITH PSEUDOPHAKIA AFTER PHAKOASIPRATION OF CONGENITAL CATARACTS WITH A PRIMARY POSTERIOR CAPUSLORHEXIS AND ANTERIOR VITRECTOMY
The frequency of secondary cataract development is analyzed in 123 eyes of children with pseudophakia within the postsurgical follow-up period (24 months). All patients underwent phakoaspiration of congenital cataract with simultaneous endocapsular implantation of hydrophobic intraocular lens (IOL) Acrysof SA30AL (Alcon). Manipulations with the posterior capsule included isolated posterior manual circular capsulorrhexis in 60 eyes (48.8%) and posterior capsulorrhexis with "dry" anterior vitrectomy in 63 eyes (51.2%). Primary posterior capsulorrhexis combined with "dry" vitrectomy reduced the prevalence of secondary cataract formation from 55.4% to 28.3% as compared to isolated posterior capsulorrhexis. It was revealed that intraoperative prophylaxis is not absolutely safe, so that in 41.4% of cases different thickness membranes with Adamyuk-Elschnig spheres, which we call "false secondary cataract", developed on the site of the postsurgical defect of the posterior capsule. Histological substrates of the "false secondary cataract", revealed by electron microscopy, are epithelial cells of the lens and fibers of the vitreous, which are located irregularly, with no particular orientation, mostly in a pathological condition, which is expressed differently depending on the patient. / Russian Ophthalmological Journal, 2009; 1:9-14