Congenital Cataracts With Persistent Fetal Vasculature And Plaques: Influence Of Clinical And Histological Findings On The Risk Of Early Postoperative Complications

To evaluate the significance of the type of persistent fetal vasculature including posterior capsule plaque on the risk of early postoperative complications in children with congenital cataract indicated for surgery.

Ophthalmology clinic of the 2nd Medical Faculty, Charles University in Prague, and the Faculty Hospital Motol

Center of eye microsurgery Ofta, Pilsen

Department of Histology and Embryology, Second Faculty of Medicine Charles University, Prague

The study includes 49 eyes of 39 patients who underwent surgery for congenital cataract in the first year of age with pathological finding of vitreolenticular interface in the form of posterior capsule plaques and/ or persistent fetal vasculature from 2017 to 2022. Based on clinical morphology and the results of histological processing of samples using basic and selective staining technique, the samples were divided into six groups depending on whether the plaques could or could not have been separated from posterior capsule and whether there were any distinctive signs of PFV. The study reports one year follow up period and the rate of complications in patients, comparing the incidence of the complications in these groups.

Following early postoperative complications were recorded: glaucoma compensated by antiglaucoma medication, glaucoma requiring antiglaucoma surgery, pupillary membranes and synechiae requiring surgery, retinal detachment following surgery for the aforementioned complications. Number of overall complications was similar in unilateral and bilateral group (37% and 30% respectively). Complications were higher in groups with signs of PFV (52% of 23 eyes) compared to eyes with only posterior capsule plaques (19% of 26 eyes). Complications were more prevalent in groups with plaques not separable from posterior capsule (40% of 37 eyes) compared to separable plaques (16% of 12 eyes). Type of complication was not significant for any of these groups.

The complications following congenital cataract surgery were more prevalent in groups with persistent fetal vasculature. Comparing the type of posterior capsule plaque, the complications were more prevalent in groups with plaques not separable from posterior capsule. The type of the complication was not specific for any of these groups. This would suggest higher prevalence of complications in eyes with more severe dysgenesis of vitreolenticular interface in the form of capsular anomalies and persistent vasculature. Due to high variability of findings in these patients, higher number of samples from patients are still needed.