Abstract
Purpose :
The long-term outcomes of lens-sparing vitreous surgery for combined anterior and posterior persistent fetal vasculature syndrome (PFVS) with nonaxial lens opacification have not been well characterized. We performed a retrospective case series study to describe the long-term effect on lens clarity of lens-sparing vitrectomy for PFVS.
Methods :
A retrospective chart review was conducted of patients who underwent lens-sparing vitrectomy for tractional retinal detachments associated with combined anterior and posterior PFVS with nonaxial lens opacification between 2006 and 2015 at a single tertiary referral pediatric vitreoretinal practice. Patients with at least 3 years of postoperative follow-up were included. Patients were excluded if any surgery had been performed at an outside institution before referral, or if they had genetic testing results or a known family history consistent with familial exudative vitreoretinopathy or Norrie disease. The main outcome measures were retinal reattachment after lens-sparing vitrectomy, cataract extraction after lens-sparing vitrectomy, lens status at the last follow-up and best corrected visual acuity at the last follow-up.
Results :
Eleven eyes of 10 patients (6 male and 4 female) met the inclusion criteria for the study. The mean age at the time of lens sparing vitrectomy was 6.25 months (range: 0.5 months – 5 years). The average postoperative follow-up time was 7.6 years (range: 3 – 11 years). The reattachment rate after a single lens-sparing vitrectomy surgery was 81.8% (9 of 11 eyes). Reattachment was achieved after a second lens-sparing vitrectomy in one eye, and one eye was found to have an inoperable redetachment. Cataract extraction was performed in 3 eyes (27.3%) due to progressive lens opacity at an average of 1.4 years (range: 1 -2 years) after the lens sparing vitrectomy. At the last follow-up 90.9% (10 of 11 eyes) were attached. 72.7% (8 of 11) were phakic, 18.2% (2 of 11) were pseudophakic, and one eye was aphakic. Best corrected visual acuity was 20/158 (range: 20/30 – NLP).
Conclusions :
Lens clarity is observed in most eyes after lens-sparing vitrectomy for combined anterior and posterior PFVS with nonaxial lens opacification. Cataract extraction, when necessary, is most often performed 1-2 years following lens-sparing vitrectomy.
This abstract was presented at the 2019 ARVO Annual Meeting, held in Vancouver, Canada, April 28 - May 2, 2019.