title: Comparison of retinal outcomes after scleral buckle or lens-sparing vitrectomy for stage 4 retinopathy of prematurity.
abstract: OBJECTIVE
  To compare anatomic outcomes after lens-sparing vitrectomy (LSV) or scleral buckle (SB) for stage 4 retinopathy of prematurity (ROP).
  
  
  METHODS
  Nonrandomized, retrospective study of infants consecutively treated for stage 4 ROP by LSV or SB. Outcomes were retinal attachment at 1 month of initial surgery and at the end of follow-up (6 months) and number of procedures to achieve retinal attachment. Exact chi2 methods determined significance, and student's t-test compared mean postmenstrual age and birthweight between the groups.
  
  
  RESULTS
  After one procedure, LSV (72%) was associated with retinal attachment more often than was SB (31%). At the end of follow-up, after one or more procedures, there was no difference in retinal reattachment rate between LSV or SB as the first procedure. There were no differences between the surgical groups by mean postmenstrual age and birthweight or severity of ROP determined by zone, clock hours of ridge elevation, or quadrants of plus disease.
  
  
  CONCLUSIONS
  This study supports the hypothesis that vitrectomy by LSV stops progressive stage 4 ROP. As an initial procedure, LSV was associated with retinal attachment more often than SB. Future prospective studies can determine the effects of LSV and SB on visual development in progressive stage 4 ROP.
authors.affiliation: Department of Ophthalmology, University of North Carolina, Chapel Hill, North Carolina 27599-7040, USA. hartnet@med.unc.edu
authors.forename: M Elizabeth
authors.initials: ME
authors.lastname: Hartnett
authors.forename: Srilakshmi
authors.initials: S
authors.lastname: Maguluri
authors.forename: Hilary W
authors.initials: HW
authors.lastname: Thompson
authors.forename: Janet R
authors.initials: JR
authors.lastname: McColm
mesh_terms: D001724:Birth Weight; D005260:Female; D005500:Follow-Up Studies; D005865:Gestational Age; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D012160:Retina / Q000033:anatomy & histology*; D012163:Retinal Detachment / Q000601:surgery*; D012178:Retinopathy of Prematurity / Q000145:classification / Q000601:surgery*; D012189:Retrospective Studies; D012591:Scleral Buckling / Q000379:methods*; D016896:Treatment Outcome; D014792:Visual Acuity / Q000502:physiology*; D014821:Vitrectomy / Q000379:methods*