Measurements, Reoperation Rates, and Outcomes in Persistent Fetal Vasculature with Elongated Ciliary Processes
Nichelle A. Warren, MD; Rupal H. Trivedi, MD; M. Edward Wilson, MD
Medical University of South Carolina
Introduction: Outcomes and reoperation rates in infants with persistent fetal vasculature (PFV) with elongated or stretched ciliary processes are typically unknown due to exclusion from infantile cataract surgery studies. The purpose of this study is to compare the pre-operative measurements, reoperation rates, and complications in PFV with stretched processes versus PFV without stretched processes.
Methods: In this non-randomized retrospective case series eighteen eyes operated for cataract surgery before 7 months of age were included, and were divided into those with stretched processes and those without. Preoperative measurements, complications, reoperations, and follow-up intervals were analyzed using the T-test, Chi-square, and Fisher’s exact test.
Results: Patients without stretched processes had a mean age at surgery of 2.5 ± 2.2 months compared to 2.5 ± 1.4 mo in those with elongated processes. 75%(9 out of 12) aphakic eyes with stretched processes had visual axis opacification (p>0.05, 0.523 Fisher’s exact test) and of those six of those underwent pupilloplasty. Both non-stretched and stretched processes had similar corneal diameters 10.5 ± 0.9mm and 10.6 ± 0.9mm (p>0.05), respectively. Of note, axial lengths were noted to be longer with stretched ciliary processes 18.91 ± 1.71 compared to non-stretched 18.13 ± 1.22 (p>0.05). Of patients who underwent strabismus surgery 55% (10 out of 18) had stretched ciliary processes. 10 out of 18 (55%) of stretched ciliary processes developed glaucoma.
Discussion: It is suggested that children with elongated ciliary processes have longer axial lengths and are also predisposed to developing visual axis opacification. The need for strabismus surgery and development of glaucoma are homogenous in both groups. However due to the small sample size more power is needed to make these findings statistically significant.
Conclusion: Children with stretched ciliary processes have a higher incidence of visual axis opacification. Future studies will be done analyzing whether visual axis opacification develops faster in children with stretched ciliary processes.
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