Abstract
Purpose: :
To assess the effects of scleral buckling (SB) procedures on the growth of the cornea in infants with stage 4 and stage 5 retinopathy of prematurity (ROP).
Methods: :
Between February, 1986 and March, 2004, 19 eyes in 19 preterm infants with stage 4 or 5 ROP underwent SB procedures. The fellow eyes, which did not have surgery, served as control eyes. Ten eyes had stage 4 and nine eyes had stage 5 ROP. We measured the horizontal corneal diameter (HCD) using an operating microscope while the infants were under general anesthesia before SB procedures and during a follow up period. The data were reviewed retrospectively from medical records.
Results: :
The mean follow up period after SB procedures in stage 4 infants was 16.9 months (range, 6-67 months); in stage 5 infants it was11.6 months (range, 6-20 months). HCD in the buckled eyes was smaller than that of the fellow eyes in both stage 4 (6.0 ± 4.3 % , p=.010), and stage 5 (9.2 ± 5.3 %, p=.015). The mean age at the time of SB was 3.7 months (range, 2-6 months) in stage 4 infants, and 9.2 months (range, 2-24 months) in stage 5 infants. SB was performed before the age of 1 year in 6 of the 9 stage 5 infants. In this subgroup, HCD in the buckled eyes was smaller than that of the fellow eyes by 9.9 ± 3.4 %, (p=.046). In the 3 eyes in which SB was performed after the age of 1 year, the difference in HCD between the buckled eye and the fellow eye (3.3 ± 6.6 %) was not significant (p=.442). In infants with stage 4 ROP, the retina remained reattached in all 10 eyes (100 %) at their last follow up visit; in infants with stage 5 ROP, the retina remained reattached in 7 eyes (77.8%) at their last follow up visit.
Conclusions: :
The growth of the cornea was impaired after SB in infants who were less than 1 year old at the time of the surgery. Although the study was small, the difference in the effect of SB on corneal growth according to the age at which surgery was performed may suggest an important factor related to the growth of the cornea.
Keywords: retinopathy of prematurity • vitreoretinal surgery • retinal detachment