Abstract

SA.09.09

Important aspects in surgical treatment of PFV (persistent fetal vasculature)

Mrzyk S., Wild A., Bornfeld N.
Center for Ophthalmology, University Hospital Essen

Objective: Evaluation of a sufficient surgical treatment of different PFV variations in consideration of a good functional outcome and to prevent progressive pathologic changes.
Methods: Surgical treatment of 16 children with PFV using extraction of cataract, retrolenticular fibrotic membrane combined with or without vitrectomy. This depends on extent of PFV and intraoperative complications. The patients were followed up for at least 6 month.
Results: Four patients showed a retinal detachment, 2 of them because of an intraoperative giant retinal tear, the others developed postoperative with vitreous hemorrhage, subretinal bleeding, traction or exsudatively. Thirteen children had no complications. In these cases retrolenticular fibrotic membrane could be completely seperated from lens capsule or was not completely removed in case of distinct vitreous vessels with threatening bleeding. In 3 of 16 patients the total removal was not possible and was followed by phthisis bulbi and enucleation. A cataract extraction was done in 15 of 16 cases. During follow-up a good anatomical outcome was obtained in 75%, 35% showed a visual acuity >0,2.
Conclusions: The chosen surgical technique should be based on varying degrees of PFV. Beside an isolated extraction of cataract and retrolenticular fibrotic membrane a primary or secundary vitrectomy can get necessary. In cases of mild posterior polar cataract a lensectomy could be avoided. An effective removal of retrolenticular tissue in eyes with PFV is essential for achieving a good functional and anatomical outcome and preventing severe complications.

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