Surgery for stage 5 retinopathy of prematurity: the learning curve and evolving technique.
OBJECTIVE
To describe our experience with management of eyes with stage 5 retinopathy of prematurity (ROP).


METHODS
Closed vitreoretinal surgery was done on 96 eyes of patients with stage 5 ROP. Lens was sacrificed in all but one eye. Surgery involved an attempt to clear all preretinal tissue and open the peripheral trough all round. In most instances bimanual surgery under viscoelastic was performed.


RESULTS
At last follow up, anatomical success (defined as attached posterior pole) was achieved in 22.5% cases. Significant postoperative problems included reproliferation and secondary glaucoma. Only two infants obtained mobile vision.


CONCLUSIONS
Late identification of disease, lack of prior treatment such as laser or cryo, and higher incidence of narrow-narrow funnel configuration were responsible for the poor surgical results noted in this series. The poor surgical and functional results reemphasize the need for prompt screening and management of infants at risk.
Gopal
L
L
Medical and Vision Research Foundation, Chennai, India. MDSAAA35@giasmd01.vsnl.net.in
Sharma
T
T
Shanmugam
M
M
Badrinath
S S
SS
Sharma
A
A
Agraharam
S G
SG
Choudhary
A
A
D002983:Clinical Competence; D005260:Female; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D007908:Lens, Crystalline / Q000601:surgery; D008297:Male; D009885:Ophthalmology / Q000193:education*; D012086:Reoperation; D012178:Retinopathy of Prematurity / Q000145:classification / Q000601:surgery*; D012189:Retrospective Studies; D016896:Treatment Outcome; D014821:Vitrectomy / Q000379:methods*