Aim To evaluate the safety and efficacy of dry pars plana posterior capsulotomy and anterior vitrectomy in paediatric cataract surgery using 25-gauge instruments.

Methods A consecutive series of 57 paediatric patients (80 eyes) who underwent dry pars plana posterior capsulotomy and anterior vitrectomy with 25-gauge devices after in-the-bag intraocular lens (IOL) implantation were retrospectively reviewed.

Results The mean follow-up period was 13.7 (SD 8.3) months. All IOL were well centred in the capsular bags. No intraoperative complications were noted to be attributable to the small-gauge instruments. Postoperative hypotony (intraocular pressure <8 mm Hg) was observed in two eyes (2.5%), which spontaneously recovered within 3 days. Eight eyes (10%) had light fibrin reactions and two eyes (2.5%) had mild posterior synechiae. No reopacification of the visual axis, IOL capture, vitreous prolapse, choroidal detachment or retinal detachment was found during the follow-up.

Conclusions Dry pars plana posterior capsulotomy with anterior vitrectomy using 25-gauge instruments is safe and effective for the management of posterior lens capsule and anterior vitreous in surgery for paediatric cataract.