Persistent Fetal Vasculature With Elongated Ciliary Process: Surgical Impact on Outcomes

To explore the results and reoperation frequencies in infants with a cataract associated with persistent fetal vasculature (PFV) characterized by elongated ciliary processes, analyze the outcomes of surgery, and determine whether it is essential to remove fibrosis and make cuts around the ciliary processes.

The criteria for selection included having cataract surgery in one eye before reaching 7 months of age and having elongated ciliary processes along with an anterior persistent fetal vasculature. Patients with involvement of the retina or a follow-up period of less than 6 months were not considered. All individuals received lensectomy, posterior capsulectomy, and vitrectomy as part of their treatment.

The research involved 21 eyes from 21 individuals with an average age of 6.3 weeks at the time of surgery and an average monitoring period of 18.9 months. All patients had their eyes aphakic after surgery. Opacification of the visual axis was observed in 6 eyes (28%). Only 1 of the 21 patients achieved a visual acuity better than 20/200. Five of 21 eyes had an incomplete removal of the retrolental membrane without circumferential cuts around the ciliary processes.

Eyes treated for PFV that have elongated ciliary processes frequently require additional surgery. Complete or near-complete removal of the retrolental membrane, along with circumferential cuts around the ciliary processes, can lower the risk of recurrent fibrosis and the need for additional surgery to clear the visual axis.