Korean J Ophthalmol.  2012 Aug;26(4):277-284. 10.3341/kjo.2012.26.4.277.

Long-term Results of Lens-sparing Vitrectomy for Progressive Posterior-type Stage 4A Retinopathy of Prematurity

  • 1Department of Ophthalmology, Inje University Sanggye Paik Hospital, Seoul, Korea.
  • 2Department of Ophthalmology, Seoul National University College of Medicine, Seoul, Korea. ysyu@snu.ac.kr
  • 3Seoul Artificial Eye Center, Seoul National University Hospital Clinical Research Institute, Seoul, Korea.


To assess the long-term anatomic and visual outcomes and associated complications of lens-sparing vitrectomy (LSV) in infants with progressive posterior-type tractional retinal detachment (TRD) associated with stage 4A retinopathy of prematurity (ROP).
In a retrospective case series, the medical records of consecutive patients who presented with progressive posterior-type stage 4A ROP and underwent LSV between 1999 and 2007 were reviewed. Retinal attachment status, visual acuity, and development of postoperative complications were assessed.
Eleven eyes of 9 patients were included. The mean follow-up period was 4.6 years. In 8 eyes (73%), plus disease was present at the time of LSV. In 3 eyes (27%), 2 (66%) without plus disease and 1 (13%) with plus disease, the retina remained reattached in the end, while 8 eyes (73%) had TRD on final examination. Two eyes with reattached retinas showed favorable visual acuity. In those eyes with detached retinas, 5 (68%) showed no light perception. When surgery for ROP was unsuccessful, development of cataract, corneal opacity, or glaucoma was common.
The long-term anatomic success rate of LSV for progressive posterior-type stage 4A ROP was low, especially in the presence of plus disease at the time of LSV. Anatomical reattachment is very important for preventing complications and gaining better visual outcomes.


Lens-sparing vitrectomy; Plus disease; Posterior; Retinopathy of prematurity; Stage 4A
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