Korean J Ophthalmol.  2006 Jun;20(2):113-117. 10.3341/kjo.2006.20.2.113.

Lens-sparing Vitrectomy for Stage 4 and Stage 5 Retinopathy of Prematurity

• Yu YS
• Kim SJ
• Kim SY
• Choung HK
• Park GH
• Heo JW

• KMID: 1099046
• DOI: http://doi.org/10.3341/kjo.2006.20.2.113

Abstract

PURPOSE: 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.

Keyword

Lens-sparing vitrectomy; Retinal detachment; Retinopathy of prematurity

MeSH Terms

Vitrectomy/*methods
Treatment Outcome
Severity of Illness Index
Scleral Buckling/methods
Retrospective Studies
Retinopathy of Prematurity/complications/pathology/*surgery
Retinal Detachment/etiology/pathology/surgery
Retina/*pathology
Male
Lens, Crystalline/*surgery
Infant, Newborn
Infant
Humans
Follow-Up Studies
Female
Child, Preschool

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