[Surgery of posterior polar cataract in persistent hyperplastic primary vitreous]

Between 1975 and 1982 surgery was performed on 13 eyes with posterior polar cataract and persistent hyperplastic primary vitreous (PHPV), in order to prevent loss of the eye due to the usual complications. Depending on the extent of the retrolental fibrovascular tissue, one of two possible surgical procedures was employed: (1) scissor excision through a large corneal incision in the wide-open bulb (8 eyes) in cases with a very firm, coarse and extensive retrolental membrane; (2) excision with a vitrectomy instrument, from a corneal or corneoscleral approach (5 eyes) in the "closed eye" in cases where the membrane was more circumscribed. A pars plana approach is generally contraindicated, as sensory retina often extends as far as the pars plicata. There were no serious intraoperative or postoperative complications. Prolonged local corticosteroid therapy is advisable postoperatively. In one patient, suffering from the anomaly in both eyes, there was an encouraging improvement in function to 0.6 and 0.1. The authors recommend early surgery in cases of posterior polar cataract with PHPV.