1. Long term follow up of Impact of Cortico Cleaving Hydrodissection on Posterior Capsule Opacification (PCO) after paediatric cataract surgery Samaresh Srivastava, DNB Vaishali Vasavada, MS Sajani K. Shah, DO, MS Rupal Trivedi, MD, MSCR* Abhay R. Vasavada, MS, FRCS (England) M.R. Praveen, DO Iladevi Cataract & IOL Research Centre, Ahmedabad, India * Storm Eye Institute, MUSC, USA The authors have no financial interest in this presentation

2. Vasavada AR, Dholakia SA, Raj SM et al. Effect of cortical cleaving hydrodissection on posterior capsule opacification in age-related nuclear cataracts. J Cataract Refract Surg; 2006; 32:145-150 In eyes with multiquadrant cortical cleaving hydrodissection, a significantly lower percentage of the area of central posterior capsule was involved in the development of PCO Vasavada AR, Trivedi RH, Apple DJ, et al. Randomized clinical trial of multiquadrant hydrodissection in pediatric cataract surgery Am J Ophthalmol 2003; 84-88 Cortex removal was easier and faster after multiquadrant cortical cleaving hydrodissection.

3. To evaluate the impact of multiquadrant hydrodissection on posterior capsule opacification (PCO) after pediatric cataract intraocular lens (IOL) implantation surgery Prospective, randomized, controlled trial This study comprised 43 eyes of children undergoing pediatric cataract surgery with IOL implantation Prospective, randomized, controlled trial This study comprised 43 eyes of children undergoing pediatric cataract surgery with IOL implantation Aim Study Design and Population

4. Randomization Hydrodissection n = 21 eyes No Hydrodissection n = 22 eyes Single surgeon, Standardized surgical procedure PCCC < 2 years PCCC + Vitrectomy - 2-6 years Intact PC > 6 years 3-piece AcrySof IOL implantation Single surgeon, Standardized surgical procedure PCCC < 2 years PCCC + Vitrectomy - 2-6 years Intact PC > 6 years 3-piece AcrySof IOL implantation Materials and methods

5. Results P value <0.05 statistically significant

6. Results P = 0.03 83 MONTHS HYDRODISSECTION GROUP 59 MONTHS NO HYDRODISSECTION GROUP Mean Survival Time from Cataract Surgery to Secondary Intervention

7. (PCO) with hydrodissection (A), and without hydrodissection (B) in eyes with PCCC anterior vitrectomy. (PCO) with hydrodissection (A), and without hydrodissection (B) in eyes with PCCC

8. Development of PCO between the two groups was not statistically significant However, we report the trend towards decreasing incidence and delay in developing visually significant PCO Development of PCO between the two groups was not statistically significant However, we report the trend towards decreasing incidence and delay in developing visually significant PCO Strengths : Longer follow-up Limitation : Smaller sample size Conclusion

9. Implications Despite of lack of statistical significance, we believe that it is clinically important and will recommend multiquadrant hydrodissection during pediatric cataract surgery, unless contraindicated due to questionable posterior capsule integrity