Abstract：
OBJECTIVE: To describe a new surgical technique and outcomes of lens-sparing vitrectomy and retrolental stalk dissection in posterior persistent fetal vasculature (PFV).
METHODS: Retrospective interventional case series.
METHODS: RESULTS: Among the 21 included eyes, 8 (38%) had no macular involvement and 4 (19%) presented with microphthalmia. Median age at the first surgery was 8 months (range: 1-113 months). Surgical success was obtained in 71.4% of cases (15 of 21). In the remaining cases, the lens was removed because of capsular rupture in 2 cases (9.5%) and a large capsular opacity after stalk removal or an adherent stalk impossible to dissect in 4 cases (19.1%). In the capsular bag, IOL implantation was accomplished for all but 1 eye. None of the eyes developed retinal detachment or required glaucoma surgery. Endophthalmitis occurred in 1 eye. Secondary lens aspiration was needed in 3 eyes after a mean interval of 10.7 months following initial surgery. At last follow-up, half of the eyes remained phakic.
CONCLUSIONS: Lens-sparing vitrectomy is a useful approach to addressing the retrolental stalk in selected cases of persistent fetal vasculature syndrome. By delaying or avoiding lens extraction, this approach allows preservation of accommodation, reduction of the risk of aphakia, glaucoma, and development of secondary lens reproliferation.
METHODS: Retrospective interventional case series.
METHODS: RESULTS: Among the 21 included eyes, 8 (38%) had no macular involvement and 4 (19%) presented with microphthalmia. Median age at the first surgery was 8 months (range: 1-113 months). Surgical success was obtained in 71.4% of cases (15 of 21). In the remaining cases, the lens was removed because of capsular rupture in 2 cases (9.5%) and a large capsular opacity after stalk removal or an adherent stalk impossible to dissect in 4 cases (19.1%). In the capsular bag, IOL implantation was accomplished for all but 1 eye. None of the eyes developed retinal detachment or required glaucoma surgery. Endophthalmitis occurred in 1 eye. Secondary lens aspiration was needed in 3 eyes after a mean interval of 10.7 months following initial surgery. At last follow-up, half of the eyes remained phakic.
CONCLUSIONS: Lens-sparing vitrectomy is a useful approach to addressing the retrolental stalk in selected cases of persistent fetal vasculature syndrome. By delaying or avoiding lens extraction, this approach allows preservation of accommodation, reduction of the risk of aphakia, glaucoma, and development of secondary lens reproliferation.
摘要：
目的：描述保留晶状体的玻璃体切除术和后牙茎剥离术在后持续性胎儿血管系统（PFV）中的新手术技术和结果。
方法：回顾性介入病例系列设置：三级转诊中心研究人群：在2011年6月至2021年9月期间，所有出现后PFV并有后牙柄和透明晶状体的儿童。
■25-G保留晶状体的玻璃体切除术和后牙柄剥离术。
方法：（1）手术成功：手术完成无晶状体抽吸；（2）安全性：继发性视网膜脱离，青光眼,或二次晶状体混浊。
结果：在21只纳入的眼睛中，8例（38%）无黄斑受累，4例（19%）出现小眼症。首次手术的中位年龄为8个月（范围：1-113个月）。71.4%的病例获得手术成功(15/21)。在其余案件中,2例（9.5％）因囊膜破裂而摘除晶状体，4例（19.1％）因茎摘除后囊膜混浊或粘连茎无法解剖而摘除晶状体。在袋中，除一只眼睛外，所有眼睛都完成了IOL植入。没有一只眼睛出现视网膜脱离或需要青光眼手术。一只眼发生眼内炎。初次手术后平均间隔10.7个月后，三只眼睛需要进行二次晶状体抽吸。在最后的随访中，一半的眼睛仍然是phakic。
结论：保留晶状体的玻璃体切除术是解决某些持续性胎儿血管系统综合征病例的后牙柄的有效方法。通过延迟或避免镜头取出，这种方法可以保留住宿，降低无晶状体的风险，青光眼,和继发性晶状体再增殖的发展。
方法：回顾性介入病例系列设置：三级转诊中心研究人群：在2011年6月至2021年9月期间，所有出现后PFV并有后牙柄和透明晶状体的儿童。
■25-G保留晶状体的玻璃体切除术和后牙柄剥离术。
方法：（1）手术成功：手术完成无晶状体抽吸；（2）安全性：继发性视网膜脱离，青光眼,或二次晶状体混浊。
结果：在21只纳入的眼睛中，8例（38%）无黄斑受累，4例（19%）出现小眼症。首次手术的中位年龄为8个月（范围：1-113个月）。71.4%的病例获得手术成功(15/21)。在其余案件中,2例（9.5％）因囊膜破裂而摘除晶状体，4例（19.1％）因茎摘除后囊膜混浊或粘连茎无法解剖而摘除晶状体。在袋中，除一只眼睛外，所有眼睛都完成了IOL植入。没有一只眼睛出现视网膜脱离或需要青光眼手术。一只眼发生眼内炎。初次手术后平均间隔10.7个月后，三只眼睛需要进行二次晶状体抽吸。在最后的随访中，一半的眼睛仍然是phakic。
结论：保留晶状体的玻璃体切除术是解决某些持续性胎儿血管系统综合征病例的后牙柄的有效方法。通过延迟或避免镜头取出，这种方法可以保留住宿，降低无晶状体的风险，青光眼,和继发性晶状体再增殖的发展。
