Anatomic Outcomes of Lens-Sparing Vitrectomy for Stage 3 or 4 Familial Exudative Vitreoretinopathy

Purpose: To report the anatomic outcomes and retinal structure changes from lens-sparing vitrectomy (LSV) for eyes with Stage 3 or 4 familial exudative vitreoretinopathy (FEVR). Methods: We retrospectively reviewed 133 consecutive eyes of 119 patients with Stage 3 (51 eyes) or 4 (82 eyes) FEVR who underwent LSV between January 2012 to May 2023. Results: 129 eyes (97.0%) achieved traction relief through one LSV operation. The extent of retinal detachment extent improved in 98 eyes (73.7%), remained stable in 32 eyes (24.1%), and progressed in 3 eyes (2.3%). At long-term follow-up, 39 (29.3%) and 60 (45.1%) eyes had completely or partially reattached retina, respectively. The median change of venular angle was 3.6° (95% CI, 3.5 to 10.5; P < 0.001) and -9.9° (95% CI, -15.8 to -4.6; P < 0.001) for temporal and nasal vessels. The mean disc-fovea distance was 0.3 papillary diameter shorter (95% CI, -0.4 to -0.2; P < 0.001) and mean temporal venular arcade distance was 0.02 papillary diameter larger (95% CI, -0.16 to 0.21; P = 0.361). Conclusions: These results suggest that LSV can relieve vitreoretinal traction and reattach the retina in late Stage FEVR eyes. Improvements in temporal and nasal venular angle, and disc-fovea distance reflect positive retinal structure changes for patients.