Tip of the iceberg: congenital cataract with pre-existing posterior capsule defect (PPCD): how vital is the role of ultrasound biomicroscopy?

Description

A 14-month-old female child presented to the outpatient clinic with abnormal white reflex of the left eye (LE) noticed by parents for the last 6 months. The right eye (RE) had similar history and was operated for a white cataract at an outside hospital 3 months before. Intraoperatively, pre-existing posterior capsule defect (PPCD) was noted in the RE with inadvertent lens matter drop, which occurred after hydrodissection and was removed subsequently. The PPCD was quite large and the RE had to be left aphakic. Anterior segment examination of the LE with fully dilated pupil showed total cataractous lens with invisible posterior capsular details (figure 1A). Ultrasound biomicroscopy (UBM) of the LE showed a large posterior capsular defect with subluxation of the lens into the vitreous cavity1 beyond the capsule (figure 1B). Care was taken to avoid lens drop during irrigation–aspiration. Viscoat can be used to coat the area of the PPCD to temporarily seal the defect....

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