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J.A. Fortun, R.R. Lakhanpal, E.R. Holz; Lensectomy and Vitrectomy With and Without Intravitreal Triamcinolone Acetonide for Vascularly Active Stage 5 Retinal Detachments in Retinopathy of Prematurity . Invest. Ophthalmol. Vis. Sci. 2006;47(13):5323.
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To determine the anatomic success rate of lensectomy and vitrectomy with and without intravitreal triamcinolone acetonide for vascularly active Stage 5 tractional retinal detachments due to Retinopathy of Prematurity (ROP).
In a retrospective, interventional, single–surgeon, consecutive case series, the records of 21 eyes of 21 patients presenting with stage 5 retinal detachment secondary to ROP that underwent a primary pars plicata vitrectomy with lensectomy from February 1998 to January 2004 were evaluated. All eyes were vascularly active at the time of surgery. Eleven eyes underwent the surgical procedure without intravitreal injection of triamcinolone acetonide (group 1) and 10 eyes received intravitreal medication at the end of the procedure (group 2). The main outcome measure, retinal reattachment, was reviewed at final follow–up visit, which ranged from 6 to 42 months (mean, 28 months) after surgery.
Two eyes, one from each group, had documented intraoperative tears during surgery, remained detached during follow–up, and were excluded from the study. None of the eyes in group 1 maintained attachment while 6 of 9 eyes in group 2 (66.7%) maintained at least posterior pole reattachment at final visit. None of the group 2 eyes exhibited plus disease during follow–up. None of the eyes in either group exhibited signs of increased intraocular pressure after surgery.
Vascularly active stage 5 ROP detachments portend a poor prognosis. The use of intravitreal triamcinolone acetonide as a postoperative adjunct may improve the likelihood of retinal reattachment in these selected cases.
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