Rhegmatogenous Retinal Detachment In Former Premature Patients With and Without Retinopathy of Prematurity: Results Of Pars Plana Vitrectomy

Abstract

Abstract: : Purpose:To describe the indications and results of pars plana vitrectomy for rhegmatogenous retinal detachment (RD) in former premature patients with and without retinopathy of prematurity (ROP). Methods:Between 1997 and 2001 a vitrectomy was performed in a consecutive series of 7 eyes of 6 children. 4 boys and 2 girls (twins), aged from 9 to 17 years, were treated. Gestational age was 26-28 weeks and birth weight was 810-1475 g (mean: 1052g). Results:All eyes were myopic (-2.5 sph equiv. -17.5 sph equiv.) and had a RD. Two patients initially presented with a vitreous hemorrhage and a RD was detected during ultrasound examination. One of these 2 children had an Ablatio Falciformis in the second eye. The other child was previously treated with cryotherapy during acute phase stage 3+ ROP. Three eyes had no peripheral changes due to ROP. In all 7 eyes a primary vitrectomy without scleral buckling was performed. Four eyes were treated with SF6 tamponade and 3 eyes with silicone oil tamponade. Patients were followed for 5 months to 3 years (mean 20.3 months). At the end of follow-up in 5 eyes the retina was completely attached. One eye was phthitic and needed a permanent silicone oil tamponade. One eye developed a subretinal fold and optic disc atrophy. In this eye follow-up was only 5 months and the silicone oil is not yet removed. Two eyes with cicatricial changes of ROP needed multiple procedures (with silicone oil) for reattachment. Visual acuity ranged from light projection to 20/25. Conclusion:Patients with a history of premature birth may develop a rhegmatogenous retinal detachment even in eyes without clinically visible retinal changes of ROP. Good anatomical and functional results could be obtained in eyes without peripheral retinal changes. Eyes with cicatricial stages of ROP required multiple procedures for stabilization. Former premature patients should be informed about the symptoms and possibility of retinal problems.

Keywords: 572 retinopathy of prematurity