Abstract
Abstract: :
Purpose: To compare retinal reattachment (RA) with lens-sparing vitrectomy (LSV) to scleral buckling (SB) in Stage 4 retinopathy of prematurity (ROP). Methods: This was a retrospective, comparative consecutive case series. Twenty-six eyes (21 patients) with stage 4 ROP underwent LSV or encircling SB as a first procedure. Infants underwent surgery between 35 and 52 weeks post-conceptual age. Exact chi-square analysis was performed comparing RA and type of surgery (LSV or SB). Subsequent analyses were performed comparing type of surgery and post-conceptual age, birthweight, gestational age, and number of procedures needed to achieve RA. Results: Ten eyes had a LSV as the first procedure and 16 had a SB. There were no differences in post-conceptual age at first surgery, gestational age, or birth weight between eyes that had LSV and those that had SB as the first procedure. 47% (12/26 eyes) had RA after one procedure; 73% (19/26) required more than one procedure to achieve RA. 70% (7/10) of eyes treated with LSV compared to 31% (5/16) of eyes treated with SB had RA after one procedure (p=0.0538) and 80% (8/10) of eyes treated with a LSV had RA on the last visit compared to 69% (11/16) treated with SB (p=0.6680). On average, eyes that had SB as the first procedure required more procedures (mean = 3) compared to eyes that had LSV as the first procedure (mean=1.6; p=0.0021). Conclusions: LSV was as effective as SB as a first procedure in achieving RA in this sample. Infants treated with LSV may require fewer procedures compared those treated with SB.
Keywords: retinopathy of prematurity • retinal detachment • vitreoretinal surgery