A Classification-Guided Approach To Anterior Segment–Predominant Persistent Fetal Vasculature And Surgical Outcomes
Published 2026 - 44th Congress of the ESCRS
Reference: FP15.03 | Type: Free paper | DOI: 10.82333/kc7d-b413
Authors: Hui Chen* 1 , Wan Chen 1 , Fengqi Zhou 2 , Chaokun Luo 1 , Zhuoling Lin 1 , Xiaoyan Li 1 , Yongbin Lin 1 , Haotian Lin 1 , Weirong Chen 1
1Zhongshan Ophthalmic Center,Guangzhou,China, 2Mayo Clinic College of Medicine and Science,Minnesota,United States
Purpose
To characterize the clinical presentation, treatment strategies, and outcomes of anterior segment–predominant persistent fetal vasculature (aPFV) using a structured classification system.
Setting
A tertiary referral pediatric ophthalmology center with longitudinal clinical follow-up.
Methods
Baseline demographic data, ocular biometric measurements, best-corrected visual acuity (BCVA), and slit-lamp findings were collected at initial presentation. Eyes with aPFV were categorized into three anatomical subtypes based on the predominant location of vascular remnants: type I (pupil–iris–anterior lens plane), type II (retrolental–anterior hyaloid membrane plane), and type III (combined involvement). Each subtype was further stratified into mild (a) or severe (b) forms according to structural complexity. Surgical approaches were documented. Visual outcomes, postoperative complications including ocular hypertension, adverse events, and the need for secondary surgical interventions were evaluated during follow-up.
Results
Among 470 patients (619 eyes), 20.8% were classified as type I, 67.9% as type II, and 11.3% as type III. Cataracts occurred in 81.6% of eyes with distinct subtype-specific patterns. Structural severity increased from type I to III, with type III showing the shallowest anterior chamber and highest corneal astigmatism. Surgery was performed in 96.9% of eyes. Postoperative complications were mainly ocular hypertension, while reoperation was required in 7.6%. Visual acuity improved in 73.7% of eyes, whereas severe subtypes (IIb and IIIb) were associated with the poorest outcomes.
Conclusions
Anterior segment–predominant PFV can be effectively stratified using a classification framework that integrates lesion location and disease severity. This approach facilitates risk assessment and supports a tailored surgical and medical management strategy, enabling satisfactory visual outcomes with an acceptable rate of perioperative complications.