title: Vitreoretinal surgery for advanced retinopathy of prematurity: presentation and outcomes from a developing country.
abstract: OBJECTIVE
  To study the outcome of pars plana vitrectomy performed on patients with stage 4b and stage 5 retinopathy of prematurity and to examine differences in clinical presentation from developed countries.
  
  
  METHODS
  Observational prospective case series.
  
  
  METHODS
  Babies with stage 4b or 5 retinopathy of prematurity who underwent vitrectomy.
  
  
  METHODS
  The study was undertaken at a tertiary care ophthalmology centre in a developing country. Demographic variables, postnatal risk factors, and anatomic and visual status were noted preoperatively. Patients with stage 4b ROP underwent a 3-port lens-sparing vitrectomy. Those with stage 5 ROP additionally underwent lensectomy and retrolental membrane dissection. Patients were assessed on their last follow-up for anatomic, visual, and functional results. Statistical evaluation was performed using the nonparametric Wilcoxon rank sum test.
  
  
  RESULTS
  The results were evaluated by number of eyes treated, except for functional score. In 21 patients, 31 eyes underwent operation, of which 20 were stage 4b and 11 were stage 5. Anatomic success was achieved in 18 eyes (90%) with stage 4b. Mean vision in this anatomically successful group was 3.765, and the functional score was 5.36. In stage 5 eyes, anatomic success was achieved in 5 eyes (45.45%). Mean vision in this anatomically successful group was 1.833, and the functional score was 3. The visual results of stage 4b cases, compared with stage 5, were significantly better (p=0.0387).
  
  
  CONCLUSIONS
  Larger, older babies and previously unablated eyes presented with retinopathy of prematurity for surgery compared with developed countries. Anatomic, visual, and (notably) functional recovery was found in a good percentage of eyes.
authors: H.V. Desai Eye Hospital, Pune, India. Electronic address: drgadkari@gmail.com.
authors: Salil
authors: S
authors: Gadkari
authors: H.V. Desai Eye Hospital, Pune, India.
authors: Rushita
authors: R
authors: Kamdar
authors: H.V. Desai Eye Hospital, Pune, India.
authors: Sucheta
authors: S
authors: Kulkarni
authors: H.V. Desai Eye Hospital, Pune, India.
authors: Nilesh
authors: N
authors: Kakade
authors: H.V. Desai Eye Hospital, Pune, India.
authors: Sudhir
authors: S
authors: Taras
authors: H.V. Desai Eye Hospital, Pune, India.
authors: Madan
authors: M
authors: Deshpande
mesh_terms: D001724:Birth Weight; D003906:Developing Countries; D005865:Gestational Age; D006801:Humans; D007194:India; D007231:Infant, Newborn; D019102:Infant, Very Low Birth Weight; D011446:Prospective Studies; D012163:Retinal Detachment / Q000601:surgery*; D012178:Retinopathy of Prematurity / Q000145:classification / Q000175:diagnosis / Q000601:surgery*; D041623:Tomography, Optical Coherence; D016896:Treatment Outcome; D014792:Visual Acuity / Q000502:physiology; D014821:Vitrectomy; D057586:Vitreoretinal Surgery