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A. Baldascino, D. Lepore, F. Molle, F. Focosi, C. Angora, L. Orazi, M. M. Pagliara, D. Ricci, F. Gallini, E. Balestrazzi; Anatomical and Structural Outcomes After Vitrectomy in ROP Stage 4b and 5. Invest. Ophthalmol. Vis. Sci. 2009;50(13):3159.
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To evaluate anatomic and functional outcome following vitrectomy for stage 4B and 5 retinopathy of prematurity (ROP) performed by a single surgeon with a minimum follow up period of two years
23 infants (42 eyes: 27 inborn and 15 outborn) with ROP-related retinal detachment underwent either lens-sparing vitrectomy (LSV) or combined lensectomy and vitrectomy (LV). 10 eyes had stage 4b ROP while Stage 5 was diagnosed in 32 eyes. The mean gestational age (GA) at surgery of the inborn population was 44,1wks (range 33, 1-74, 8 wks). The mean GA of outborn babies was 56, 7 wks (range 40.0-93, 6 wks). Anatomical outcomes of all eyes, classified as favourable or unfavourable as defined from CryoROP, were assessed by means of RETCAM fundus examination at 6 months of chronological age. Reactions to light, fixing and tracking ability of 16 babies (29 eyes; mean chronological age 22, 3 months) were evaluated by experienced paediatric neurologist.
LSV was performed in 19 eyes and LV in 23 eyes. Favourable outcomes were found in 50% of total cases. In stage 4B ROP both LSV and LV shoved 80% of favourable anatomic outcomes, while in stage 5 ROP better outcomes were found after LV (LV 55.6% vs. LSV 21.4%). In 25 eyes we found a reaction to the light while 4 eyes didn’t have any reaction to the light. 16 eyes had a clear fixation, 3 eyes had an uncertain fixation, and in 10 eyes no reaction.
in the literature LSV or LV are the only therapies proposed for ROP after laser failure. In our experience 50% of stage 4b/5 ROP showed anatomical retinal stabilisation and RLF prevention. Although only 5 eyes achieved light tracking ability, vitrectomy allowed to maintaine a clear light fixation at 2 years of age of 16 ROP satge 4b/5 eyes.
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