Long-Term Visual Outcomes Vary Among Children With Unilateral PFV-Related Cataract

A study of children who underwent surgery for unilateral nontraumatic cataract due to persistent fetal vasculature (PFV) found that 5 years after surgery, only a small percentage of eyes had achieved age-normal visual acuity (VA).

Study Design

This was a retrospective review of data on 64 eyes of 64 children enrolled in the Pediatric Eye Disease Investigator Group cataract registry who underwent lensectomy for PFV-associated unilateral cataract. Visual outcomes were compared between this population (“PFV eyes”) and children who underwent surgery for unilateral cataract not associated with PFV (“non-PFV eyes”). The median follow-up time was 58 months.

Outcomes

Seventy-five percent of the PFV eyes were aphakic and 25% of eyes were pseudophakic after surgery. Five-year follow-up data were available for 42 of the 64 eyes; of those eyes, 10% achieved age-normal VA and 48% achieved better than 20/200 VA. Visual acuity was worse in the pseudophakic eyes than in the aphakic eyes regardless of PFV or non-PFV status. In aphakic eyes, glaucoma or glaucoma suspect were the most common complications, but there was no significant difference in the rate of glaucoma between aphakic PFV and non-PFV eyes.

Limitations

One limitation of the study was its retrospective nature. Although the study included both anterior and posterior PFV cases, the number of each type of PFV was relatively small. In addition, since these patients were part of a registry and not enrolled in a specific study, they did not receive a standardized treatment regimen.

Clinical Significance

Children who underwent surgery for unilateral PFV cataracts had outcomes similar to those of children with unilateral non-PFV cataracts, with aphakic eyes achieving slightly better VA improvement.

Financial Disclosures: Dr. Brenda Bohnsack discloses no financial relationships.