Korean J Ophthalmol.  2011 Oct;25(5):305-310. 10.3341/kjo.2011.25.5.305.

Long-Term Results of Lens-Sparing Vitrectomy for Stages 4B and 5 Retinopathy of Prematurity

• Choi J
• Kim JH
• Kim SJ
• Yu YS

• KMID: 1098631
• DOI: http://doi.org/10.3341/kjo.2011.25.5.305

Abstract

PURPOSE
To assess long-term anatomic and visual outcomes and associated complications of lens-sparing vitrectomy (LSV) for treatment of tractional retinal detachments (TRDs) associated with stages 4B and 5 retinopathy of prematurity (ROP).
METHODS
We performed a retrospective review of medical records and data analyses of consecutive patients who presented with stages 4B and 5 ROP and underwent LSV from 1999 to 2007. Retinal reattachment status, visual acuity and postoperative complications were evaluated.
RESULTS
Twenty-one eyes of 20 patients, including 13 eyes with stage 4B ROP and 8 eyes with stage 5 ROP, were examined. The mean follow-up period was 5.6 years. In 9 (43%) out of 21 eyes, retinas were eventually reattached. The anatomic success rates were 62% in stage 4B and 13% in stage 5 ROP. In eyes with reattached retinas, visual acuity better than form vision was shown in 7 eyes (78%), whereas no light perception was present in 10 eyes (83%) among eyes with TRD on final examination. Postoperative intraocular hemorrhage occurred in nine eyes (43%). Long-term complications of cataract, corneal opacity, glaucoma and strabismus developed in 4 (19%), 6 (29%), 7 (33%) and 8 (38%) eyes, respectively, and were more common in eyes with TRD.
CONCLUSIONS
After following-up for a mean of 5.6 years, the anatomical success rate of LSV was encouraging for the correction of TRD associated with stage 4B ROP but not for stage 5 ROP. Retinal reattachment is important for obtaining better visual outcomes and preventing the development of late complications.

Keyword

Lens-sparing vitrectomy; Retinopathy of prematurity; Stage 4B; Stage 5; Tractional retinal detachment

MeSH Terms

Female
Follow-Up Studies
Humans
Infant, Newborn
*Infant, Very Low Birth Weight
Lens, Crystalline/*surgery
Male
Retinopathy of Prematurity/diagnosis/physiopathology/*surgery
Retrospective Studies
Severity of Illness Index
Time Factors
Treatment Outcome
Visual Acuity
Vitrectomy/*methods

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