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Presentation type	Oral presentation
Title	Keeping the visual axis clear:Double optic capture in paediatric cataract surgery

Purpose	To analyse the incidence of visual axis opacification (VAO) after paediatric cataract surgery in patients younger than 18 years old at University Hospitals Leuven. The correlation between VAO and evolving surgical approaches was evaluated, comparing aphakia, in-the-bag intraocular lens (IOL) implantation with or without posterior capsulorhexis, and double optic capture (DOC).
Methods	Data from all paediatric cataract surgeries performed at the University Hospitals Leuven between 2004 and 2025 in patients younger than 18 years old with a minimum follow-up of 6 months were retrospectively analysed. VAO rates were evaluated in relation to the different surgical approaches.
Results	A total of 239 eyes from 165 patients were analysed, with a median age at surgery of 25.1 months. 86 eyes remained aphakic, 17 received an in-the-bag IOL, 103 received an in-the-bag IOL with posterior capsulorhexis, and 22 underwent DOC. The incidence of VAO surgery was 29.1%, 58.8%, 23.3% and 9.1%, respectively. An anterior vitrectomy reduces the need for VAO surgery in aphakic eyes and in eyes with in-the-bag IOL with posterior capsulorhexis. After DOC VAO surgery was needed in two eyes. Both eyes underwent an anterior vitrectomy, indicating the importance of the vitreolenticular interface.
Conclusion	Analysis of our paediatric cataract surgery database suggests that DOC is safe and appears more effective in reducing VAO surgery compared to the conventional techniques. In addition, a routine anterior vitrectomy plays a paradoxical role during cataract surgery. It is indicated in the conventional techniques, but it is not recommended in DOC.
Conflict of interest	No

Authors 1

Last name	VERLEYEN
Initials	E
Department	UZ Leuven
City	Leuven

Authors 2

Last name	Casteels
Initials	I
Department	UZ Leuven
City	Leuven

Authors 3

Last name	Cassiman
Initials	C
Department	UZ Leuven
City	Leuven

Authors 4

Last name	Van Aerschot
Initials	J
Department	UZ Leuven
City	Leuven

Authors 5

Last name	Saelens
Initials	I
Department	UZ Leuven
City	Leuven