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This study aimed to evaluate the intra- and postoperative complications of intraocular lens (IOL) implantation with posterior optic buttonholing (POBH) in children that had undergone phacoemulsification irrigation/aspiration for congenital/developmental cataract and experienced complication of anterior capsulorrhexis extension (ACE). A total of 25 eyes of 21 patients were included in the study. A foldable three-piece IOL was implanted into the bag/ciliary sulcus with primary posterior capsulorrhexis and POBH. The visual acuity improved from 2.12 ± 0.69 log MAR to 1.38 ± 0.49 log MAR at 6 months follow-up. Postoperative complications included heightened postoperative inflammation in three patients and temporary corneal edema in two patients. Only one patient had developed posterior capsular opacification (PCO) at 6 months follow-up with mild tilt, while the rest 24 eyes had no PCO formation and adequate IOL centration. The results of this study indicate that a three-piece foldable IOL implantation with POBH is a feasible option for children who experienced ACE during pediatric cataract surgery, as it results in satisfactory surgical outcomes and very few ocular complications.

Posterior optic buttonholing of intraocular lens implantation through posterior capsulorrhexis margin