Surgical results of persistent hyperplastic primary vitreous

Area of Science:

• Ophthalmology
• Pediatric Ophthalmology
• Surgical Outcomes

Background:

• Persistent hyperplastic primary vitreous (PHPV) is a congenital condition affecting ocular development.
• PHPV can present with anterior, posterior, or combined disease components, impacting visual prognosis.

Purpose of the Study:

• To assess the surgical success in patients diagnosed with PHPV.
• To identify preoperative factors that predict visual outcomes in PHPV cases.

Main Methods:

• A noncomparative case series analyzed 35 eyes of 27 patients diagnosed with PHPV between 1982 and 1994.
• Data collected included PHPV classification, preoperative assessments, surgical procedures, and long-term visual outcomes.
• Twenty-nine eyes underwent surgical management, with follow-up ranging from 2 months to 12 years.

Main Results:

• The majority of PHPV cases (71.4%) involved both anterior and posterior segments.
• Initial lensectomy and vitrectomy were performed in 68.6% of eyes; surgery was withheld in severe cases with unrecordable visual-evoked potentials (VEPs).
• The reoperation rate was 32.3% for complications including membrane reproliferation and glaucoma. Despite posterior involvement, 17% of eyes achieved functional vision.

Conclusions:

• Surgical treatment for PHPV offers potential for functional visual recovery, even in cases with posterior segment disease.
• The extent of ocular malformation is a key factor limiting visual improvement.
• Preoperative evaluations, particularly VEP, are valuable in selecting appropriate surgical candidates for PHPV.