Surgical treatment of a unilateral congenital cataract with persistent hyperplastic primary vitreous using double optic capture with a 20 year follow-up and review of the literature.

Purpose: To describe the long term follow-up of surgical intervention with the technique of Double Optic Capture to surgically treat a unilateral congenital cataract with hyperplastic primary vitreous and the ability to perform intraocular lens exchange of a double captured intraocular lens 17 years after the initial procedure. Observations: An eight week old with unilateral cataract with persistent hyperplastic primary vitreous of the left eye had cataract surgery which included anterior capsulorhexis, a primary posterior capsulorhexis, anterior vitrectomy and placement of a posterior chamber intraocular lens implantation through both capsulotomy openings (double optic capture). Fourteen years later, patient was best corrected to 20/20 vision with a refraction of -14.75-2.00 x 100. Due to difficulties with anisometropia, the patient underwent successful intraocular lens exchange. The intraocular lens was able to be successfully removed from its double captured position and a new implant was successfully re-captured through the fused capsule. Two years follow-up after IOL exchange, the implant was well centered and clear of any secondary membranes or scar tissue with a best corrected visual acuity of 20/20-2. Conclusions: This represents one of the longest reported follow-up with not only unilateral cataract with persistent hyperplastic primary vitreous, but also of the technique of double optic capture and successful intraocular lens exchange following the technique of double optic capture.