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W.-C. Wu, C.-C. Lai, K.-J. Chen, Y.-S. Hwang, T.-L. Chen, A.-N. Chao, Y.-H. Kuo; Vitrectomy for Stage 4A Retinopathy of Prematurity (ROP). Invest. Ophthalmol. Vis. Sci. 2009;50(13):3136.
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To report the surgical outcome of stage 4A retinopathy of prematurity (ROP) by vitrectomy in Chang Gung Memorial Hospital, Taoyuan, Taiwan.
This retrospective study evaluated the efficacy and safety of vitrectomy on stage 4A ROP (partially retinal detachment without involving macula) from year 2006 until 2008. The anatomical reattachment of stage 4A ROP was viewed as a primary outcome. The complications associated with this surgical technique were also reviewed.
There were 9 patients (16 eyes) included in the study. Before surgery, all of the eyes had received pan-retinal photocoagualation (PRP) one to 3 times for the pre-threshold ROP. Despite laser treatment, retinopathy progressed to partially retinal detachment (stage 4A) in all eyes. After vitrectomy, twelve eyes (12/16; 75%) were successfully reattached with one surgery. Two eyes progressed to stage 4B ROP requiring an additional vitrectomy and had complete retinal reattachment after surgery. The final retinal reattachment was achieved in 14 eyes (88%). Two eyes progressed to full retinal detachment (stage 5 ROP). After additional surgeries, these 2 eyes had partially retinal reattachment. Complications included preretinal hemorrhage in 4 eyes (25%), glaucoma in 2 eyes (13%), cataract in 2 eyes (13%), and vitreous hemorrhage in one eye (6%).
Vitrectomy for stage 4a ROP could achieve retinal reattachment for the majority of patients with acceptable complication rate.
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