[A new surgical technique in congenital cataracts for prevention of regenerated cataract. Controlled central excision of capsular leaves with endodiathermy coagulation of the capsular sac periphery].

Inherent in all operative methods of congenital cataract surgery with the aim of preserving the posterior leaf of the capsule is the risk of recurrence. Even after phakectomy of the pars plicata, secondary cataract can occur in the peripheral remains of the capsule, and this method also entails the risk of retinal detachment and loss of the capsule diaphragm, which would otherwise allow subsequent IOL implantation. We developed a new surgical technique to preserve the peripheral capsular sac and to avoid secondary cataract within the optical axis. Unipolar diathermy coagulation was applied to the anterior peripheral leaf of the capsule, provided that both leaves of the capsule were touching when slight pressure was applied to the probe. In preliminary studies of autopsy eyes, fusion of the capsular leaves was clearly apparent, even if the lens epithelium was not morphologically destroyed by diathermy coagulation. These were 42 eyes with congenital cataract (12 children with bilateral cataract, 9 eyes with mild anterior PHPV syndrome). Their ages were between 4 weeks and 8.5 years and the period from April 1988 to December 1992; follow-up was 1 to 4.5 years: 36 eyes, 6 eyes with PHPV. The following operation was undertaken in the children. After central anterior capsulectomy and aspiration of the lens, the anterior and posterior leaves of the capsular sac were fused circularly at the periphery by unipolar endodiathermy coagulation. The posterior chamber was deepened by viscoelastic substance allowing diathermy application at the anterior capsule with risk.(ABSTRACT TRUNCATED AT 250 WORDS)