Anatomic success rate after 3-port lens-sparing vitrectomy in stage 4A or 4B retinopathy of prematurity.
OBJECTIVE
To assess the anatomic success rate after 3-port lens-sparing vitrectomy (LSV) in stage 4A and 4B tractional retinal detachments (TRDs) due to retinopathy of prematurity (ROP).


METHODS
A chart review and data evaluation of 108 eyes of 102 consecutive patients presenting with stage 4A (32 eyes) or 4B (76 eyes) TRDs that underwent primary LSV from February 1998 to January 2004 were performed.


METHODS
Three-port LSV was performed on all eyes by the same surgeon (ERH).


METHODS
Retinal reattachment status was reviewed at final follow-up visit, which ranged from 6 to 48 months (mean, 32 months) after LSV.


RESULTS
Ninety-two of 108 (85.2%) eyes were reattached after a single LSV and 102 of 108 (94.4%) eyes ultimately achieved at least partial posterior pole reattachment at the final follow-up visit. All 4A eyes achieved complete reattachment and 70 of 76 (92.1%) 4B eyes achieved partial or complete reattachment. Reversal or complete arrest of dragging of the macula was noted in all eyes that maintained partial or complete reattachment (94.4%). Six (5.6%) 4B eyes remained detached despite additional vitreoretinal procedures; 4 (66.7%) of these had intraoperative retinal tears.


CONCLUSIONS
Eighty-five percent of eyes with 4A and 4B TRDs secondary to ROP were completely reattached with a single 3-port LSV procedure and nearly 95% were ultimately at least partially reattached at the posterior pole by the final follow-up visit. The development of retinal tears intraoperatively portended a poor prognosis for reattachment.
Lakhanpal
Rohit R
RR
Section of Vitreoretinal Diseases and Surgery, Baylor College of Medicine, Houston, Texas 77030, USA.
Sun
Regina L
RL
Albini
Thomas A
TA
Holz
Eric R
ER
D018450:Disease Progression; D005260:Female; D005466:Fluorocarbons / Q000008:administration & dosage; D005865:Gestational Age; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D019102:Infant, Very Low Birth Weight; D008297:Male; D012163:Retinal Detachment / Q000209:etiology / Q000601:surgery*; D012167:Retinal Perforations / Q000209:etiology / Q000601:surgery*; D012178:Retinopathy of Prematurity / Q000145:classification / Q000150:complications / Q000601:surgery*; D012827:Silicone Oils / Q000008:administration & dosage; D016896:Treatment Outcome; D014792:Visual Acuity / Q000502:physiology; D014821:Vitrectomy / Q000379:methods*
D005466:Fluorocarbons; D012827:Silicone Oils; C042852:perflutren