Lens-sparing vitrectomy for stage 4 and stage 5 retinopathy of prematurity.
OBJECTIVE
To describe the results of lens-sparing vitrectomy for the correction of retinal detachment associated with retinopathy of prematurity (ROP) and its associated complications.


METHODS
Seventeen patients who underwent a lens-sparing vitrectomy for stage 4 and stage 5 ROP with plus disease at Seoul National University Children' s Hospital between 1999 and 2003 were enrolled in this study. The patients who had bilateral retinal detachment of ROP underwent a lens-sparing vitrectomy in one eye and a scleral buckling surgery or lensectomy-vitrectomy in the other eye. The patients who had a retinal detachment in one eye and a regressed ROP in the other eye underwent unilateral lens-sparing vitrectomies. A review of their preoperative clinical findings (including the status of retinal detachment and plus disease), post-operative results, and any complications encountered was performed.


RESULTS
In 17 patients, the postoperative success rate of lens-sparing vitrectomy was 58.8%. However, lens-sparing vitrectomy as a treatment for stage 5 ROP (25.0%) produced more negative post-operative results than it did when used to treat either those for stage 4a (75,0%) or 4b (66.7%) ROP. Among the 10 eyes in which the retina was attached, form vision was shown in six eyes, light could be followed by three eyes, and no light perception was present in one eye. Intra- and post-operative complications included retinal break formation, cataracts, vitreous hemorrhages, and glaucoma in patients with stages 4b and stage 5 ROP.


CONCLUSIONS
Lens-sparing vitrectomy resulted in encouraging surgical outcomes in the correction of retinal detachment of ROP, especially in stage 4 patients. Therefore, a lens-sparing vitrectomy for stage 4 ROP patient may be beneficial, although it is still associated with some intra- and post-operative complications.
Yu
Young Suk
YS
Department of Ophthalmology, Seoul National University College of Medicine, #28 Yeongeon-dong, Jongro-gu, Seoul 110-744, Korea. ysyu@snu.ac.kr
Kim
Seong-Joon
SJ
Kim
So Young
SY
Choung
Ho Kyung
HK
Park
Gyu Hyung
GH
Heo
Jang Won
JW
D002675:Child, Preschool; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D007908:Lens, Crystalline / Q000601:surgery*; D008297:Male; D012160:Retina / Q000473:pathology*; D012163:Retinal Detachment / Q000209:etiology / Q000473:pathology / Q000601:surgery; D012178:Retinopathy of Prematurity / Q000150:complications / Q000473:pathology / Q000601:surgery*; D012189:Retrospective Studies; D012591:Scleral Buckling / Q000379:methods; D012720:Severity of Illness Index; D016896:Treatment Outcome; D014821:Vitrectomy / Q000379:methods*