Long-term anatomic and visual outcomes of vitrectomy for retinopathy of prematurity stage 4B and 5

Session Details

Session Title: Free Paper Session 6: Vitreoretinal Surgery II

Session Date/Time: Thursday 07/09/2017 | 14:30-16:00

Paper Time: 15:30

Venue: Room 111

First Author: : S.Pignatto ITALY

Co Author(s): :    A. Capone   E. Gusson                          

Abstract Details

Purpose:

To retrospectively assess the long-term anatomic and visual outcomes of vitrectomy for treatment of retinal detachment associated with stages 4B and 5 retinopathy of prematurity (ROP) in a consecutive series of 70 eyes.

Setting:

University of Verona Eye Clinic

Methods:

We performed a retrospective review of medical records and data analyses of 70 eyes of 38 consecutive patients affected by stages 4B and 5 ROP that underwent vitrectomy from 1999 to 2013. All babies in this series were diagnosed in a paediatric ophthalmology unit in Italy and sent for surgery to a vitreoretinal paediatric surgeon in the USA. After surgery, patients were than again followed by the same unit of provenience. We collected the following data at the last follow-up examination: visual acuity, grade of retinal attachment and long-term ophthalmic complications

Results:

At the moment of surgery, on 70 eyes (38 babies), 23 eyes presented with a stage 4B and 47 eyes with stage 5. Lens sparing vitrectomy (LSV) was performed in 11 eyes( 6 eyes 4B and 5 eyes 5). In all the other eyes vitrectomy was combined with lensectomy due to the presence of vitreoretinal adherence in the far retina periphery. Mean follow-up was 8.5 years (range 2-16, median 6.5 years). Long-term anatomic success (stable posterior retinal attachment) was obtained in 41 eyes (58.5%), 19 eyes with stage 4B (82.6%) and 22 eyes with stage 5 ( 46.8 %). Among the 41 eyes with attached retina, visual acuity better than form vision was obtained in 17 eyes (41.4 %). During follow-up, intraocular haemhorrage occurred in six eyes (8.6%). Additional complications encountered during follow up were corneal opacity in 3 eyes (4.3%), glaucoma in 10 eyes (14,3%) and phthisis in 5 eyes (7,1%), and were more common in eyes without retinal attachment

Conclusions:

After following-up for a mean of 8.5 years, the visual and anatomical success rates as well as complication rate following lensectomyvitrectomy was encouraging for the correction of retinal detachment associated with ROP stage 4B and 5. Retinal reattachment offers the opportunity for superior visual outcome as compared to the untreated natural history of advanced ROP related retinal detachment.

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