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B. T. Chan-Kai, A. K. Lauer; Transconjunctival, Sutureless 25-Gauge Lens Sparing Vitrectomy for Stage 4 Retinopathy of Prematurity Related Retinal Detachments. Invest. Ophthalmol. Vis. Sci. 2008;49(13):1395.
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To describe a surgical approach for treatment of stage 4 retinopathy of prematurity (ROP) related retinal detachments utilizing 25 gauge vitrectomy instrumentation.
Retrospective review of all patients with stage 4A and 4B ROP related retinal detachments that were treated with sutureless transconjunctival 25-gauge vitrectomy between August 2003 and February 2007 was performed.
Eight eyes of 6 patients were studied. Of these, 7/8(88%) were stage 4A ROP retinal detachments. Six of 7 eyes (86%) with 4A retinal detachments achieved a good anatomical result at the last follow-up examination. One of 7 eyes (14%) progressed to stage 4B ROP postoperatively. There was one stage 4B ROP retinal detachment patient with rush disease that was treated with a primary 25-gauge lens sparing vitrectomy. This eye progressed to a stage 5 detachment one week postoperatively.
In treating infants with stage 4A ROP related retinal detachment, sutureless transconjunctival 25-gauge vitrectomy can be an effective surgical technique in selected cases. Its benefits include shorter time spent on wound construction and closure and better intraocular visualization and maneuverability afforded by smaller instrumentation in these small eyes. Proper case selection is critical for infants who would benefit from this surgical approach.
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