Risk factors for recurrent fibrovascular proliferation in aggressive posterior retinopathy of prematurity after early vitreous surgery.
OBJECTIVE
To analyze risk factors for postoperative recurrence of fibrovascular tissue in eyes with aggressive posterior retinopathy of prematurity (AP ROP) treated with early vitreous surgery.


METHODS
Retrospective, consecutive, observational case series.


METHODS
Thirty-one patients (50 eyes) with AP ROP who underwent early vitreous surgery between March 2005 and April 2008 participated. Eyes with stage 4A or 4B disease in which fibrovascular tissue was not attached to the vitreous base were included; those in which fibrovascular tissue was attached extensively to vitreous base or those without dense photocoagulation to the nonvascularized retina were excluded. Eligible eyes were divided into 2 groups based on postoperative recurrence or no recurrence of fibrovascular tissue. Data on gender, gestational age, birth weight, Apgar score, intubation duration, severe systemic complications, preoperative ROP stage, zone, fibrovascular tissue and vitreous base adhesion, clock hours of fibrovascular tissue, postmenstrual age at the initial application of dense photocoagulation, dense photocoagulation to both vascularized and nonvascularized retina, postmenstrual age at vitrectomy, and intraoperative hemorrhage were collected and analyzed.


RESULTS
Fifty eyes of 31 patients underwent early vitrectomy. Seven (14%) eyes were excluded and 43 eyes (86%) were included. Eight (18%) of 43 eyes had a recurrence of fibrovascular tissue. Both univariate and multivariate analysis indicated application of dense photocoagulation to both the vascularized and nonvascularized retina was a significant factor in the decreased recurrence of fibrovascular tissue (P = .002 and P = .008, respectively).


CONCLUSIONS
Application of preoperative dense photocoagulation to vascularized and nonvascularized retina may be important for lowering the recurrence of fibrovascular tissue in eyes with AP ROP.
Yokoi
Tadashi
T
Department of Ophthalmology, National Center for Child Health and Development, Tokyo, Japan.
Yokoi
Tae
T
Kobayashi
Yuri
Y
Nishina
Sachiko
S
Azuma
Noriyuki
N
D001724:Birth Weight; D005260:Female; D005355:Fibrosis / Q000209:etiology / Q000601:surgery; D005865:Gestational Age; D006801:Humans; D007231:Infant, Newborn; D017075:Laser Coagulation; D008297:Male; D011183:Postoperative Complications; D012008:Recurrence; D012171:Retinal Vessels / Q000473:pathology* / Q000601:surgery; D012178:Retinopathy of Prematurity / Q000145:classification / Q000601:surgery*; D012189:Retrospective Studies; D012307:Risk Factors; D014821:Vitrectomy; D014822:Vitreous Body / Q000601:surgery*