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D.H. Cherwek, J.S. O'Keefe, G. Burian, G.B. Hubbard; Lens-sparing Vitrectomy for Tractional Retinal Detachment Due to Retinopathy of Prematurity (ROP) . Invest. Ophthalmol. Vis. Sci. 2003;44(13):605.
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Purpose: To evaluate the outcomes in a consecutive series of lens-sparing vitrectomy for tractional retinal detachment in advanced ROP. Methods: In an IRB approved study, the authors performed a retrospective chart review of pediatric patients with ROP, Stage 4A or 4B, who underwent lens-sparing vitrectomy by a single surgeon (GBH) to repair tractional retinal detachments. All surgically repaired eyes had previously undergone laser treatments. Results: Twenty-eight eyes from 18 patients with advanced ROP (average birth weight was 769 grams and average gestational age was 25.8 weeks) were followed for an average of 3.0 months. Nineteen eyes (67%) were stage 4A and the remaining 9 eyes (33%) were stage 4B. Twenty-three of the 28 eyes, 82%, achieved complete reattachment of the retina at last clinic visit (16 of the 19 stage 4A eyes, 84%, and 7 of 9 stage 4B eyes, 77%). Of the stage 4B eyes, 8 of the 9 (88%) eyes achieved successful attachment of the macula. Five eyes (4 of which were stage 4A) required a second vitrectomy during the observational period for persistent or recurrent traction. All cases used the lens-sparing technique and, to date, no lens has developed cataractous changes. Post-operative adverse effects included exudative retinal detachment (25%), vitreous hemorrhage (18%), glaucoma (7%), macular fold (7%), and retinal hole (4%). Conclusions: Our results show that lens-sparing vitrectomy can effectively achieve retinal reattachment without apparent injury to the lens.
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