25-gauge lens-sparing vitrectomy with dissection of retrolental adhesions on the peripheral retina for familial exudative vitreoretinopathy in infants.

BACKGROUND: To evaluate the clinical outcome of 25-gauge lens-sparing vitrectomy with dissection of retrolental adhesions on the peripheral retina for familial exudative vitreoretinopathy in infants.

METHODS: Fifty-one eyes of 39 infants with familial exudative vitreoretinopathy associated with retrolental adhesions on the peripheral retina, retinal fold with macular detachment, and partial lens opacity. A 25-gauge lens-sparing vitrectomy was performed, and retrolental adhesions between the peripheral retina and the posterior lens capsule were surgically dissected. Lens opacification, as assessed or graded by Lens Opacities Classification System III, and the retinal reattachment rate were observed and recorded monthly for up to 7 months postoperatively.

RESULTS: After 7 months, the detached retina along the retinal fold was reattached in 42/51 (82.4%) eyes; the macula was reattached completely in 26/51 (51.0%) eyes and partially in 15/51 (29.4%) eyes. There was no statistically significant change in the lens opacity of the posterior capsule or cortex before or after surgery (P > 0.05, paired t test) or in postoperative progression of lens opacity (P > 0.05, modified McNemar's test) according to Lens Opacities Classification System III scores.

CONCLUSIONS: A 25-gauge lens-sparing vitrectomy with dissection of peripheral retinal retrolental adhesions is helpful for preservation of the lens and reattachment of the macula in infants with FEVR.