Posterior Lens Capsule Defects in Children with Congenital Cataract. Literature Review

Purpose: to present a review of publications devoted to defects of the posterior lens capsule in children with congenital cataracts, as well as approaches to surgical tactics in their presence.

Materials and methods. A search was conducted for publications on posterior lens capsule defects in children with congenital cataracts from 1992 to 2024 using the electronic databases PubMed (https://www.ncbi.nlm.nih.gov/pubmed/), Google Scholar (https://scholar.google.ru/), eLIBRARY.ru (https://www.elibrary.ru/) and domestic journals (Ophthalmosurgery, Bulletin of Ophthalmology, Ophthalmology, Russian Children’s Ophthalmology, Modern Technologies in Ophthalmology).

Results. Posterior capsule defects (PCDs ДЗК) of the lens are one of the most common anomalies of the posterior capsule, along with persistent fetal vasculature (PFV ПФСС) and posterior lenticonus (PL ЗЛК). There were a sufficient number of publications on persistent fetal vasculature (275 in the PubMed database as of 10/09/2024) and posterior lenticonus (86 in the PubMed database as of 10/09/2024) in the available literature. A limited number of articles on posterior capsule defects (11 in the PubMed database as of 10/09/2024), and therefore a review of publications devoted to posterior capsule defects in congenital cataract is relevant to expand knowledge about the role of posterior capsule defects in the diagnosis and surgical treatment of this pathology.

Conclusion. Thanks to modern technologies, new opportunities are opening up for specialists to visualize, analyze and evaluate the posterior capsule of the lens, the condition of which can affect the effectiveness and safety of pediatric cataract surgery, as well as to plan surgical tactics and intraoperative prevention of complications, which guarantees the quality of surgical intervention in this category of patients.

1. Egiyan NS, Kruglova TB. Approaches to surgical treatment of congenital cataract and correction of aphakia in children with PPGST syndrome. Russian National Ophthalmological Forum. 2024;1:161–165 (In Russ.).

2. Trifanenkova IG, Tereshchenko AV, Vydrina AA, Isaev SV. Femtolaser support of congenital cataract surgery in children. Modern technologies in ophthalmology. 2024;2(4):171–172 (In Russ.). doi: 10.25276/2312-4911-2024-4-171-172.

3. Tereshchenko A, Trifanenkova I, Vlasov M. Femtosecond laser-assisted anterior and posterior capsulotomies in children with persistent hyperplastic primary vitreous. Journal of Cataract and Refractive Surgery. 2020;46(4):497–502. doi: 10.1097/j.jcrs.0000000000000139.

4. Trifanenkova IG, Tereshchenko AV, Isaev SV. Femtosecond laser-assisted anterior capsulotomy in children undergoing cataract surgery: a large case series. BMJ Open Ophthalmology. 2022;7:e000945. doi: 10.1136/bmjophth-2021-000945.

5. Titiyal J, Kaur M, Nair S, Sharma N. Intraoperative optical coherence tomography in anterior segment surgery. Surv Ophthalmol. 2021;66(2):308–326. doi: 10.1016/j.survophthal.2020.07.001.

6. Yudina NN. Modern methods of visualization in the treatment of primary persistent hyperplastic vitreous body in combination with congenital cataract. Modern technologies in ophthalmology. 2020;4(35):302 (In Russ.). doi: 10.25276/23124911-2020-4-292-293.

7. Trifanenkova IG, Tereshchenko AV, Vydrina AA. Relationship between the posterior lens capsule and the anterior hyaloid membrane in patients with congenital cataract according to intraoperative OST data. Modern technologies in ophthalmology. 2020;4(35):396 (In Russ.). doi: 10.25276/2312-4911-2020-4-396-397.

8. Ding X, Xiang L, Wang Q, Wang D, Chang P, Li Z, Zhao Y, Chu F, Ma C, Zhao YE. Clinical Characteristics and Surgical Safety in Congenital Cataract Eyes with Three Pathological Types of Posterior Capsule Abnormalities. J Ophthalmol. 2020;2020:6958051. doi: 10.1155/2020/6958051.

9. Mullner-Eidenbock A, Amon M, Hauff W, Klebermass N, Abela C, Moser E. Surgery in unilateral congenital cataract caused by persistent fetal vasculature or minimal fetal vascular remnants. Journal of Cataract & Refractive Surgery. 2004;30(3):611–619. doi: 10.1016/j.jcrs.2003.07.015.

10. Vasavada AR, Praveen RM, Nath V, Dave K. Diagnosis and management of congenital cataract with preexisting posterior capsule defect. Journal of Cataract &Refractive Surgery. 2004;30(2):403–408. doi: 10.1016/S0886-3350(03)00502-9.

11. Li Z, Chang P, Wang D, Zhao Y, Hu M, Ding X, Yu L, Zhao Y. Morphological and biometric features of preexisting posterior capsule defect in congenital cataract. J Cataract Refract Surg. 2018;44(7):871–877. doi: 10.1016/j.jcrs.2018.05.009.

12. Vajpayee RB, Sandramouli S. Bilateral congenital posterior-capsular defects: a case report. Ophthalmic Surg. 1992;23:295–296.

13. Vasavada AR, Praveen MR, Dholakia SA, Trivedi RH. Preexisting posterior capsule defect progressing to white mature cataract. J AAPOS. 2007;11(2):192–194. doi: 10.1016/j.jaapos.2006.11.115.

14. Lee BJ, Kim JH, Yu YS. Surgical outcomes after intraocular lens implantation for posterior lenticonus-related cataract according to preoperative lens status. J Cataract Refract Surg. 2014;40(2):217–223. doi: 10.1016/j.jcrs.2013.07.048.

15. Titiyal JS, Kaur M, Falera R. Intraoperative optical coherence tomography in anterior segment surgeries. Indian J Ophthalmol. 2017;65(2):116–121. doi: 10.4103/ijo.IJO_868_16.

16. Müllner-Eidenböck A, Amon M, Moser E, Klebermass N. Persistent fetal vasculature and minimal fetal vascular remnants: a frequent cause of unilateral congenital cataracts. Ophthalmology. 2004;111(5):906–913. doi: 10.1016/j.ophtha.2003.07.019.

17. Trifanenkova IG, Tereshchenko AV, Vydrina AA. Method of surgical treatment of cataract in children in combination with PFV syndrome in the presence of a spontaneous opening of the posterior lens capsule. Patent RU 2791649/06.04.2022 (In Russ.). Available from: https://patentimages.storage.googleapis.com/50/e4/88/a3b30ee09645d0/RU2791649C1.pdf (Accessed 21.10.2024).