Cataract surgery in a child with Persistent Fetal Vasculature (PFV) is surgically demanding due to the presence of a retrolental fibrovascular membrane and a hyaloid stalk. These structures often cause traction on the ciliary processes and can be firmly adherent to the posterior capsule. The surgical approach typically involves a combined lensectomy and anterior vitrectomy. Surgeons must carefully dissect the retrolental plaque and may need to use endodiathermy to cauterize the persistent hyaloid artery before severing the stalk to prevent intra-ocular hemorrhage. Because the eye is often microphthalmic with a shallow anterior chamber, maintaining stability is critical. Postoperative management requires aggressive anti-inflammatory therapy and intensive amblyopia rehabilitation to achieve a functional visual outcome, as these cases carry a higher risk of glaucoma and retinal detachment.
