PURPOSE  To evaluate the safety and efficacy of a 25-gauge transconjunctival sutureless vitrectomy (TSV 25) system for the management of congenital cataract in infants.
DESIGN  Prospective clinical study.
METHODS  The TSV 25 system was used for cataract extraction in a consecutive series of 18 infants (31 eyes) from March 2009 to September 2010. Each eye underwent anterior vitrectorhexis, lentectomy, posterior vitrectorhexis, and anterior vitrectomy procedures via a pars plana entry site created with a 25-gauge trocar. Another limbal side port was made for infusion in the anterior chamber. The eyes were left aphakic. Refraction correction with spectacles and amblyopic training began 3 to 5 days postoperatively. The mean follow-up period was 17.4 ± 6.1 months.
RESULTS  None of the sclerotomies required suturing, whereas the limbal side port in 1 eye required suturing. Retained cortex was noted in 1 eye (3.2%). Two eyes (6.5%) developed visual axis opacification (VAO) and required secondary pars plana vitrectomy 1 month and 8 months after cataract surgery, respectively. Postoperative inflammation was mild with stable intraocular pressure (IOP). Pupils were circular and centric in all cases. Two eyes (6.5%) had mild posterior synechiae.
CONCLUSIONS  Management of congenital cataract in infants via a pars plana entry site and a limbal side port using the TSV 25 system appears safe and effective. Advantages include more precise manipulations, a more stable IOP, minimized surgical-induced trauma, and decreased postoperative inflammation.