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Management and visual acuity results of monocular congenital cataracts and persistent hyperplastic primary vitreous
Authors:William E. Scott  MD    Garry T. Drummond  MD  FRCS     Ronald V. Keech  MD   Daniel J. Karr  MD
Affiliation:Department of Ophthalmology, University of Iowa Hospitals and Clinics, Iowa City, Iowa;Department of Ophthalmology, University of Iowa Hospitals and Clinics, Iowa City, Iowa;Department of Ophthalmology, University of Iowa Hospitals and Clinics, Iowa City, Iowa;Department of Ophthalmology, University of Iowa Hospitals and Clinics, Iowa City, Iowa
Abstract:Sixty-two patients, 48 with a diagnosis of persistent hyperplastic primary vitreous (PHPV) and 14 with monocular congenital cataract (MCC) are reported. Nineteen patients with a diagnosis of PHPV and all patients with MCC received surgery with attempted visual rehabilitation.
Early age of surgery, prompt optical correction with contact lens and aggressive patching therapy are required for successful visual rehabilitation. Glaucoma, retinal or optic nerve pathology, surgery later than three months of age or combinations of these factors were associated with poor prognosis. Isolated microphthalmos was not correlated with poor prognosis.
Binocular fixation pattern was used to monitor patching therapy. Optokinetic nystagmus, visual evoked potentials or forced preferential looking were not employed.
Of the 33 patients who underwent surgery, 10 (30%) achieved good (> 20/50) visual acuity, 8 (24%) achieved fair (20/60 to 20/100) and 15 (46%) achieved poor vision.
In selected patients with the diagnosis of PHPV or MCC, visual rehabilitation can be achieved.
Keywords:Monocular congenital cataracts    PHPV    visual acuity
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