Combined Cataract and Vitrectomy Surgery in Pediatric Patients

<i>Purpose:</i> To review the current literature on the combined use of cataract surgery (or lensectomy) and vitrectomy in pediatric patients, with a focus on clinical indications, surgical techniques, outcomes, and complications across various pediatric ocular pathologies. <i>Meth...

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Main Authors: Armando J. Ruiz-Justiz, Vanessa Cruz-Villegas, Stephen G. Schwartz, Victor M. Villegas, Timothy G. Murray
Format: Article
Language:English
Published: MDPI AG 2025-06-01
Series:Medicina
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Online Access:https://www.mdpi.com/1648-9144/61/7/1176
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author Armando J. Ruiz-Justiz
Vanessa Cruz-Villegas
Stephen G. Schwartz
Victor M. Villegas
Timothy G. Murray
author_facet Armando J. Ruiz-Justiz
Vanessa Cruz-Villegas
Stephen G. Schwartz
Victor M. Villegas
Timothy G. Murray
author_sort Armando J. Ruiz-Justiz
collection DOAJ
description <i>Purpose:</i> To review the current literature on the combined use of cataract surgery (or lensectomy) and vitrectomy in pediatric patients, with a focus on clinical indications, surgical techniques, outcomes, and complications across various pediatric ocular pathologies. <i>Methods:</i> A narrative review of published studies addressing the use of combined lensectomy and vitrectomy (LV) in pediatric patients was conducted. Conditions discussed include congenital cataracts, ectopia lentis, retinopathy of prematurity (ROP), retinal detachment (RD), and persistent fetal vasculature (PFV). Key surgical considerations, visual and anatomical outcomes, and postoperative complications were examined. <i>Results:</i> The literature search yielded a total of 160 articles, of which 43 met the inclusion criteria and were included in this review. Although lens-sparing vitrectomy (LSV) is preferred in many pediatric cases to preserve accommodation and reduce complications, combined LV is often necessary in advanced or complex diseases. Studies have shown that combined LV can achieve favorable anatomical outcomes, but functional visual recovery remains variable and is affected by factors such as patient age, baseline ocular anatomy, and disease severity. Postoperative complications such as glaucoma, visual axis opacification (VAO), and intraocular lens (IOL) dislocation are more frequent with combined procedures and require long-term follow-up and rehabilitation. <i>Conclusions:</i> Combined cataract surgery (or lensectomy) and vitrectomy may represent a valuable strategy in the management of complex pediatric ocular conditions, particularly when individualized to the clinical context. Tailored surgical approaches are essential to optimize anatomic and functional outcomes. Further prospective studies and harmonized multicenter registries are needed to develop evidence-based principles that can guide individualized surgical decision-making in this unique patient population.
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spelling doaj-art-6ea6f413cbfb4f4bbd4e8ef83cc1fd852025-08-20T03:35:38ZengMDPI AGMedicina1010-660X1648-91442025-06-01617117610.3390/medicina61071176Combined Cataract and Vitrectomy Surgery in Pediatric PatientsArmando J. Ruiz-Justiz0Vanessa Cruz-Villegas1Stephen G. Schwartz2Victor M. Villegas3Timothy G. Murray4Department of Ophthalmology, University of Puerto Rico School of Medicine, San Juan, PR 00936, USADepartment of Ophthalmology, University of Puerto Rico School of Medicine, San Juan, PR 00936, USADepartment of Ophthalmology, Bascom Palmer Eye Institute, University of Miami Miller School of Medicine, Miami, FL 33136, USADepartment of Ophthalmology, University of Puerto Rico School of Medicine, San Juan, PR 00936, USAMiami Ocular Oncology & Retina (MOOR), Miami, FL 33143, USA<i>Purpose:</i> To review the current literature on the combined use of cataract surgery (or lensectomy) and vitrectomy in pediatric patients, with a focus on clinical indications, surgical techniques, outcomes, and complications across various pediatric ocular pathologies. <i>Methods:</i> A narrative review of published studies addressing the use of combined lensectomy and vitrectomy (LV) in pediatric patients was conducted. Conditions discussed include congenital cataracts, ectopia lentis, retinopathy of prematurity (ROP), retinal detachment (RD), and persistent fetal vasculature (PFV). Key surgical considerations, visual and anatomical outcomes, and postoperative complications were examined. <i>Results:</i> The literature search yielded a total of 160 articles, of which 43 met the inclusion criteria and were included in this review. Although lens-sparing vitrectomy (LSV) is preferred in many pediatric cases to preserve accommodation and reduce complications, combined LV is often necessary in advanced or complex diseases. Studies have shown that combined LV can achieve favorable anatomical outcomes, but functional visual recovery remains variable and is affected by factors such as patient age, baseline ocular anatomy, and disease severity. Postoperative complications such as glaucoma, visual axis opacification (VAO), and intraocular lens (IOL) dislocation are more frequent with combined procedures and require long-term follow-up and rehabilitation. <i>Conclusions:</i> Combined cataract surgery (or lensectomy) and vitrectomy may represent a valuable strategy in the management of complex pediatric ocular conditions, particularly when individualized to the clinical context. Tailored surgical approaches are essential to optimize anatomic and functional outcomes. Further prospective studies and harmonized multicenter registries are needed to develop evidence-based principles that can guide individualized surgical decision-making in this unique patient population.https://www.mdpi.com/1648-9144/61/7/1176lensectomy-vitrectomycongenital cataractsectopia lentisretinopathy of prematurityretinal detachmentpersistent fetal vasculature
spellingShingle Armando J. Ruiz-Justiz
Vanessa Cruz-Villegas
Stephen G. Schwartz
Victor M. Villegas
Timothy G. Murray
Combined Cataract and Vitrectomy Surgery in Pediatric Patients
Medicina
lensectomy-vitrectomy
congenital cataracts
ectopia lentis
retinopathy of prematurity
retinal detachment
persistent fetal vasculature
title Combined Cataract and Vitrectomy Surgery in Pediatric Patients
title_full Combined Cataract and Vitrectomy Surgery in Pediatric Patients
title_fullStr Combined Cataract and Vitrectomy Surgery in Pediatric Patients
title_full_unstemmed Combined Cataract and Vitrectomy Surgery in Pediatric Patients
title_short Combined Cataract and Vitrectomy Surgery in Pediatric Patients
title_sort combined cataract and vitrectomy surgery in pediatric patients
topic lensectomy-vitrectomy
congenital cataracts
ectopia lentis
retinopathy of prematurity
retinal detachment
persistent fetal vasculature
url https://www.mdpi.com/1648-9144/61/7/1176
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