IMPROVED SURGICAL-TREATMENT OF FAMILIAL EXUDATIVE VITREORETINOPATHY IN CHILDREN

PURPOSE: To evaluate current surgical results in patients with familia l exudative vitreoretinopathy and study the histologic findings of epi retinal membranes obtained at the time of surgery. METHODS: We perform ed phakic pars plana vitrectomy and membrane peeling on five patients (six eyes) with familial exudative vitreoretinopathy, who ranged in ag e from 18 months to 9 years and had traction retinal detachment. Membr anes from two eyes (two patients) were analyzed by light and electron microscopy. RESULTS: The macula was reattached in all six eyes. Visual acuity improved after surgery in five of the six eyes, with two eyes improving from a preoperative visual acuity of 20/400 to a postoperati ve visual acuity of 20/25 and 20/60. Electron microscopic analysis of the membranes from two patients disclosed thick fibrocellular fragment s with vascular elements and astrocytes. CONCLUSION: With current surg ical techniques, there appears to be improvement in the anatomic reatt achment rate and visual outcome in patients with familial exudative vi treoretinopathy. Amblyopia, reproliferation, and vitreous hemorrhage m ay limit long-term improvement in vision.