When I saw the blood vessel, I was really unprepared and didn’t know what the fundus would be like. I quickly reviewed the preoperative ultrasound and UBM again and found nothing wrong. I quickly asked the fundoplication department to examine the stage and found no other abnormalities in the fundus except for the thin blood vessel. After consulting with them, the fundoplication specialist did not recommend surgery because he thought that biosurgery in infants and children would lead to vitreous hyperplasia and the later effect would be unpredictable. However, if we do not treat it, the clouding and vascular mass is basically in the center of the posterior capsule, which will seriously affect future visual training and development. Although surgery for congenital cataracts in children is all about just doing a very limited anterior biosection, it is really uncertain whether the severed vessels will lead to hemorrhage or continue to bleed subsequently, causing vitreous hyperplasia. It may be possible to electrocoagulate the vessels first and then do a limited biosurgery. However, in the end, the patient’s parents are the kind of people who have no knowledge of science and cannot understand it. It is totally different from the same channel. Besides, if this parent had understood better, he would not have delayed the surgery until 14 months. To be on the safe side, I planned to make a 4-5mm circular incision in the center of the posterior capsule, leaving only the nasal side and the lower two vessels untouched, to see if the cloudy posterior capsule and the vascular mass could be shifted to the side of the visual axis. Figure 1: Later, when it was not completely removed, the lower vessels were tried to be cut off and very little bleeding was observed. Figure 2: Thus the vascular mass was shrunk to one side, the pupillary area was transparent, and a limited anterior biosketch was done. Figure 3: Then the IOL was implanted with good position and no obvious postoperative inflammation, but the vision was only light perception and required follow-up continued visual training. Discussion: 1. Primitive vitreous immortality is known to everyone, but the principles of treatment need to be further clarified. Especially this kind of cases are mostly encountered by cataract surgeons, and the treatment should rely on the help of posterior segment doctors. According to the discussion, the preference is for underwater electrocoagulation and then limited anterior biosurgery. But the key is that I dare not ensure that there is no bleeding, and the patient’s postoperative vision is definitely not good, so I still choose to be cautious; 2. The patient is more fortunate that the blood vessels are relatively fine, the fundus lesions are almost absent, and there is still hope that the postoperative visual training can improve the vision. So I still decided to implant the child with an IOL. But the key for the patient was the clouding of the central capsule. Therefore, I considered moving this clouded posterior capsule with its vascular mass aside so that it would not bleed and would not affect the visual axis. The result was still ideal.