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C. Angora, L. Orazi, D. Lepore, F. Molle, M. M. Pagliara, G. D'Amico, A. Baldascino, M. Laguardia, F. Lafranceschina, E. Balestrazzi; Is It Worth to Remove the Lens During Vitrectomy for Stage 4b and 5 ROP?. Invest. Ophthalmol. Vis. Sci. 2008;49(13):1391. doi: https://doi.org/.
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to evaluate the usefulness of lens removal in vitrectomy for stage 4 and 5 ROP.
from August 2004 to November 2007 , 42 eyes of 24 pre-term babies (9 of them outborn) underwent vitrectomy for stage 4b and 5 ROP. Lens sparing vitrectomy (LSV) was performed in 20 eyes (11 babies) at mean postcoceptional age (PCA) of 45.9 weeks . In 22 eyes (14 babies) we performed vitrectomy and lensectomy at the same time. Structural result after a mean follow up of 10 months (ranging from 3 months to 28 months) were evaluated.
cataract is a common late complication of retinal surgery. In our experience all LSV-treated babies developed some degree of lens opacities within 12 to 24 months after surgery. 10 eyes from 7 babies required late lensectomy. The mean time of cataract removal was 96.9wks PCA . A 59% of favourable outcomes ( as defined by Cryo-ROP study) was found in babies underwent lensectomy and vitrectomy at the same time against a 25% of favourable outcomes in LSV.
lens removal allows a wide and more complete peeling of preretinal fibrosis in stage 4b and 5 ROP. On the other hand LSV save the normal anatomy of the eyes and reduces postoperative recovery -time together with the risk of synechiae. In our experience LSV advantages are overwhelming with better retinal results we have been able to achieve with vitrectomy with lens removal.
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