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Outcomes of pediatric cataract surgery in anterior persistent fetal vasculature
Abhay R Vasavada1, Shail A Vasavada, Nadiya Bobrova
1Iladevi Cataract & IOL Research Center, Memnagar, Ahmedabad, India. icirc@abhayvasavada.com
Insights
Surgical intervention for anterior persistent fetal vasculature (PFV) in infants can lead to good visual outcomes. This study demonstrates effective surgical techniques for PFV, achieving improved vision in most cases with manageable complications.
Area of Science:
- Ophthalmology
- Pediatric ophthalmology
- Surgical innovation
Background:
- Anterior persistent fetal vasculature (PFV) is a congenital condition affecting the eye.
- Early surgical intervention is crucial for managing PFV and preventing vision loss.
Purpose of the Study:
- To evaluate the surgical performance and visual outcomes in pediatric eyes with anterior persistent fetal vasculature (PFV).
- To assess the efficacy of standardized surgical techniques, including plaque peeling, excision, and vitrectomy, for anterior PFV.
Main Methods:
- A prospective interventional case series involving 33 eyes with anterior PFV.
- Surgical techniques included plaque peeling, partial excision, extensive capsulectomy, and anterior 2-port limbal vitrectomy.
- Intraocular lens implantation was performed selectively based on microphthalmia.
Main Results:
- The mean age at surgery was 6.3 months; 30.3% of eyes had microcornea.
- Cataractous changes ranged from fibrovascular mass to lens opacity, requiring varied surgical approaches.
- At 3-year follow-up, 66.6% of eyes showed improved visual acuity, with a low rate of visual axis obscuration.
Conclusions:
- Surgical intervention for anterior PFV can yield favorable visual outcomes.
- Standardized surgical techniques are effective in managing PFV, offering a good prognosis for visual recovery.
- The study highlights an acceptable rate of serious postoperative complications, supporting surgical intervention.
Purpose:
To report the intraoperative performance and postoperative outcomes in eyes with anterior persistent fetal vasculature (PFV).
Setting:
Iladevi Cataract & IOL Research Centre, India, and Filatov Institute Odessa, Ukraine.
Design:
Prospective interventional case series.
Methods:
Eyes with anterior PFV had surgery using a standardized surgical technique. Plaque peeling was used for small plaques and partial excision for larger plaques. In eyes in which the entire lens converted into a fibrovascular tissue, extensive capsulectomy with anterior 2-port limbal vitrectomy was performed. Microphthalmic eyes had no intraocular lens implantation.
Results:
This study comprised 33 eyes. The mean age at surgery was 6.30 months ± 5.16 (SD). Microcornea was observed in 10 eyes (30.3%). Within the morphology of cataract, 10 eyes (30.3%) had the lens converted into fibrovascular mass, of which 4 had associated prominent ciliary process. Anterior continuous curvilinear capsulorhexis (CCC) and manual posterior CCC were performed in 23 eyes (69.7%) and 3 eyes (9.1%), respectively. Intraoperatively, posterior capsule plaque was seen in 20 eyes (60.6%). In 31 eyes (93.9%), 2-port limbal anterior vitrectomy was performed and in 2 eyes (6.1%), pars plana vitrectomy was performed. Intraocular lens implantation was performed in 16 eyes (48.5%); 17 eyes (51.5%) were left aphakic. Visual axis obscuration was observed in 6 eyes (18.2%). At the 3-year follow-up, visual acuity remained stable in 11 eyes (33.3%) and improved in 22 eyes (66.6%).
Conclusion:
The results suggest that good visual outcomes can be obtained in PFV eyes after surgical intervention, with an acceptable rate of serious postoperative complications.
Financial Disclosure:
No author has a financial or proprietary interest in any material or method mentioned.
