Abstract
Purpose :
To describe a new surgical technique and outcomes of lens sparing vitrectomy and retrolental stalk dissection in posterior Persistent Fetal Vasculature (PFV)
Methods :
Design: Retrospective interventional case-series
Setting: Tertiary referral center
Population: children presenting posterior PFV with a retrolental stalk operated between June 2011 and September 2021.
Interventional procedure: 25-G lens sparing vitrectomy with retrolental stalk dissection
Main outcomes measures: surgical success defined as surgery completed without lens aspiration; occurrence of secondary retinal detachment, glaucoma, or secondary lens opacification.
Results :
Among the 21 included eyes, 8 (38%) had no macular involvement and 4 (19%) presented with microphthalmia. Median age at the first surgery was 8 months (range: 1-113 months). Surgical success was obtained in 71.4% of cases (15/21). In the remaining cases, lens was removed because of a capsular effraction in 2 cases (9.5%) and a large capsular opacity after stalk removal or an adherent stalk impossible to dissect in 4 cases (19.1%). In the bag IOL implantation was possible for all but one eye. None of the eyes developed retinal detachment or required glaucoma surgery. Endophthalmitis developed in one eye. Secondary lens aspiration was needed in three eyes after a mean interval of 10.7 months following the initial surgery. At last follow-up, half of the eyes remained phakic.
Conclusions :
Lens sparing vitrectomy and dissection of posterior PFV even located in the visual axis is possible. By delaying or avoiding the lens extraction, this approach allows to preserve accommodation, reduce the risk of aphakia and glaucoma, and limit the development of secondary lens reproliferation.
This abstract was presented at the 2023 ARVO Annual Meeting, held in New Orleans, LA, April 23-27, 2023.