title: Scleral buckling surgery for active stage 4A retinopathy of prematurity.
abstract: OBJECTIVE
  To examine the effectiveness of scleral buckling surgery for active stage 4A retinopathy of prematurity.
  
  
  METHODS
  Retrospective noncomparative case series.
  
  
  METHODS
  Eight eyes of seven infants were examined. All except one had previous peripheral ablation (cryotherapy-laser) but retinal detachment was actively progressing.
  
  
  METHODS
  Scleral buckling surgery was performed by one surgeon.
  
  
  METHODS
  Anatomic retinal status and visual acuity outcome after average follow-up of 23 months were measured.
  
  
  RESULTS
  Six (75%) of eight eyes had a complete retinal reattachment (+/- macular ectopia) after a single buckling procedure. Two eyes progressed to stage 4B despite scleral buckling but after closed limbal vitrectomy with lensectomy and membrane peeling, the retinas were reattached.
  
  
  CONCLUSIONS
  Scleral buckling for stage 4A retinopathy of prematurity is an effective means of preventing further progression of retinal detachment. The authors believe that the effect of the buckle not only relieves vitreoretinal traction but also plays a role in preventing ischemia in the detached retina that alters the natural progression of the disease.
authors.affiliation: Vitreoretinal Service, Wilmer Ophthalmological Institute, Johns Hopkins Hospital, Baltimore, Maryland 21287-9009, USA.
authors.forename: B J
authors.initials: BJ
authors.lastname: Hinz
authors.forename: E
authors.initials: E
authors.lastname: de Juan
authors.forename: M X
authors.initials: MX
authors.lastname: Repka
mesh_terms: D001724:Birth Weight; D003452:Cryosurgery; D005260:Female; D005500:Follow-Up Studies; D005865:Gestational Age; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D017075:Laser Coagulation; D008297:Male; D012163:Retinal Detachment / Q000601:surgery*; D012178:Retinopathy of Prematurity / Q000145:classification / Q000601:surgery*; D012189:Retrospective Studies; D012591:Scleral Buckling; D016896:Treatment Outcome; D014792:Visual Acuity