Outcomes and Complications 5 Years After Surgery for Pediatric Cataract Associated With Persistent Fetal Vasculature

Abstract

PurposeTo report 5-year outcomes following surgery for cataract associated with persistent fetal vasculature (PFV). DesignClinical cohort study using pediatric cataract registry data collected annually from medical records. Methods64 children <13 years of age, undergoing surgery for unilateral, non-traumatic cataract associated with PFV were included. Proportions with age-normal visual acuity (VA) and VA better than 20/200 at 5 years follow-up were estimated. Cumulative incidences of complications and additional surgeries by 5 years were calculated. Outcomes were compared between unilateral PFV eyes and eyes with unilateral non-PFV cataract from our registry. Results48 of 64 eyes were aphakic postoperatively (median age at surgery 2 months, range 1-13) and 16 were pseudophakic (29 months, range 2 to 92). Overall, 4 of 42 eyes (10%, 95% CI: 3%-23%) achieved age-normal visual acuity. VA better than 20/200 was achieved in 17 (59%, 95% CI 39%-76%) unilateral aphakic PFV eyes and 44 (43%, 95% CI 32%-54%) unilateral non-PFV aphakic eyes (age-adjusted OR=1.90; 95% CI: 0.81-4.50; P=0.14). The most common complication in aphakic PFV eyes was glaucoma-related adverse events (GRAE) (cumulative incidence 24%, 95% CI: 9%-37%). There was no significant difference in GRAE between PFV and non-PFV eyes in aphakic participants ≤1 year of age at lensectomy (age-adjusted HR=1.20, 95% CI: 0.54-2.64, P=.66). ConclusionsA wide range of visual outcomes for PFV cataract were observed with a 10% probability of achieving age-normal VA. There was an ongoing risk for the development of glaucoma-related adverse events in PFV eyes. Table of Contents StatementWe studied the outcomes of 64 children undergoing surgery for unilateral, non-traumatic cataract associated with persistent fetal vasculature; 48 were left aphakic and 16 pseudophakic. A range of visual outcomes for persistent fetal vasculature cataract were observed with a 10% probability of achieving age-normal VA. There was a 24% cumulative incidence of glaucoma-related adverse events in aphakic eyes, which was similar to that for a comparison group of eyes without persistent fetal vasculature.