Surgical results of persistent hyperplastic primary vitreous
Section snippets
Patients and methods
Twenty-seven patients with PHPV were referred to a tertiary retinal practice for evaluation and treatment from 1982 to 1994 (Table 1). Eight patients had bilateral disease, resulting in 35 eyes total for review. Five additional patients were identified but not included in the study because of lack of follow-up. The diagnosis of PHPV in each patient was made clinically by the presence of anterior and/or posterior segment findings including microphthalmos, cataract, retrolental membrane,
Results
Twenty-nine of 35 eyes were managed surgically. Two of these eyes (patients 1 and 2) had strictly anterior PHPV and were treated with lensectomy and anterior vitrectomy. Of the remaining 27 eyes, 8 had strictly posterior PHPV and 19 had components of both anterior and posterior disease. Of these 27 eyes, 24 eyes underwent primary lensectomy and vitrectomy with or without membrane peeling. Two eyes (patients 18 and 20) underwent scleral buckling as their primary procedure with one eye (patient
Discussion
Persistent hyperplastic primary vitreous is a well-described clinical entity in which early surgical management has been advocated by many authors. When described by Reese9 in 1955, a two-staged approach was recommended, consisting of needling of the lens followed by later discission of the retrolental membrane. Others also recommended variations of two-staged techniques, including open-sky dissection, to minimize hemorrhagic complications.10, 13, 14 With the advent of vitreous cutting
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