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Intraocular lens implantation in combination with lensectomy and vitrectomy for persistent fetal vasculature

  • Pediatrics
  • Published:
Graefe's Archive for Clinical and Experimental Ophthalmology Aims and scope Submit manuscript

Abstract

Purpose

To present surgical outcomes following intraocular lens (IOL) implantation in combination with lensectomy and vitrectomy for the treatment of persistent fetal vasculature (PFV).

Methods

This interventional case series included 19 eyes from 19 patients with unilateral combined PFV. Limbal lensectomy, capsulotomy, anterior vitrectomy, dissection of the retrolental membrane and stalk, and in-the-bag or in-the-sulcus IOL implantation were performed for the treatment of visually significant lenticular opacity with the presence of a retrolental fibrovascular membrane and stalk, in an eye with sufficient capsular support. Postoperative anatomical and visual outcomes were evaluated.

Results

After 22 to 50 months of follow-up, IOLs were well positioned in 18 (95%) of 19 eyes. Retinal dragging was reversed in all 8 eyes with preexisting peripapillary tractional retinopathy. Major complications occurred in 2 eyes (11%): one eye (5.5%) of vitreous hemorrhage and posterior capsular opacity and one eye (5.5%) of IOL dislocation. Nine (47%) of 19 eyes achieved best-corrected visual acuity (BCVA) above 20/200. Myopic shift after IOL implantation ranged from 0.75 to 4.17 D. Compared with eyes with poorer BCVA, eyes with BCVA above 20/200 had a better preoperative BCVA (mean 20/400 vs. 20/4000, P = 0.004) and were less likely to have preexisting peripapillary tractional retinopathies (11% vs. 70%, P = 0.002).

Conclusion

Primary IOL implantation in combination with lensectomy and vitrectomy is an alternative to treat eyes with combined PFV. Prospects for rehabilitation may be limited by poor preoperative visual function and the presence of tractional retinopathies preoperatively. Postoperative refractive status requires long-term monitoring.

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Data availability

The raw data and materials were available on requirement.

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Acknowledgments

The authors thank the participating patients and the medical staff of Xinhua Hospital Affiliated to Shanghai Jiao Tong University School of Medicine.

Funding

The authors thank the National Natural Science Foundation Project of China (81,800,837 to Jiao Lyu and 81,770,964 to Peiquan Zhao) for funding this study.

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Authors and Affiliations

  1. Department of Ophthalmology, Xinhua Hospital, School of medicine, Shanghai Jiao Tong University, 1665 Kong Jiang Road, Shanghai, 200092, China

    Jiao Lyu & Peiquan Zhao

Authors
  1. Jiao Lyu
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  2. Peiquan Zhao
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Contributions

Jiao Lyu collected and analyzed data and drafted the work; Peiquan Zhao designed and revised the work.

Corresponding author

Correspondence to Peiquan Zhao.

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Conflict of interest

The authors declare that they have no conflict of interest.

Ethics approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards. Ethical approval was waived by the Ethics Committee of Xinhua Hospital in view of the retrospective nature of the study, and all the procedures being performed were part of the routine care.

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Informed consent to participate in the study was obtained from legal guardians of the participants.

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Informed consent to publish the data in the study was obtained from legal guardians of the participants.

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Lyu, J., Zhao, P. Intraocular lens implantation in combination with lensectomy and vitrectomy for persistent fetal vasculature. Graefes Arch Clin Exp Ophthalmol 258, 2849–2856 (2020). https://doi.org/10.1007/s00417-020-04880-9

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  • DOI: https://doi.org/10.1007/s00417-020-04880-9

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