Therapeutic Effect Observation of Surgery on Congenital Fibrovascular Pupillary Membrane.

Abstract

Purpose: To retrospectively analyze the clinical characteristics and therapeutic outcomes of congenital fibrovascular pupillary membrane (CFPM).

Methods: Twelve children (13 eyes) diagnosed as having CFPM between November 2017 and January 2024 in Qingdao Eye Hospital were retrospectively reviewed. Basic information and ophthalmic examination results were analyzed. Different treatment outcomes were monitored. Pathological analysis was performed using hematoxylin-eosin staining.

Results: Three eyes (25%) received conservative treatment, whereas 10 eyes (83.3%) underwent membranectomy. Compared to fellow eyes, the affected eyes exhibited increased central corneal and lens thickness, with decreased central anterior chamber depth (all P < .05). No significant difference was observed in mean pre-operative intraocular pressure between the affected and fellow eyes, both within normal range. The median best corrected visual acuity (BCVA) for non-surgical cases was 0.9 llogarithm of the minimum angle of resolution (og-MAR) (Snellen equivalent of 0.125) with miosis. Surgical treatment improved the natural pupil size and median BCVA to 0.4 logMAR (Snellen equivalent of 0.4). Postoperative amblyopia was 100% and 33.3% in patients who underwent surgery after age 3 years and at or before 3 years, respectively (P = .035). No surgery-induced cataracts or recurrence in cases of unilateral involvement was noted. Histopathological analysis revealed that the excised tissue consisted of proliferative fibrous and vascular tissues with infiltrated inflammatory cells.

Conclusions: Affected eyes in CFPM exhibit a thickened cornea and lens with a shallow anterior chamber, typically without glaucoma. Surgery is a safe and effective treatment with low recurrence and fewer complications compared to limited conservative treatment. Performing surgery before age 3 years reduces amblyopia risk. CFPM may be linked to chronic inflammation from incomplete degeneration of fetal eye vasculature. [J Pediatr Ophthalmol Strabismus. 20XX;XX(X):XXX-XXX.].