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Sui Chien Wong, Damien Yeo, Robert Henderson, CK Patel; Acute retinal detachment in retinopathy of prematurity: UK national outcomes of endoscopic vitrectomy in 51 consecutive cases.. Invest. Ophthalmol. Vis. Sci. 2018;59(9):3757. doi: https://doi.org/.
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© ARVO (1962-2015); The Authors (2016-present)
To evaluate the efficacy and safety of endoscopic vitrectomy (Endo-Vit) for acute traction RD in ROP.
This was a noncomparative consecutive case series of surgery for traction RD in ROP (stage 4), between November 2014 and August 2017. Inclusion criteria was stage 4A, 4B or 4B/5 ROP. True Stage 5 cases were excluded. All cases had primary simultaneous high-resolution 19 gauge endoscopy (Endo-Vit) and 23 gauge vitrectomy.
Fifty-one eyes of 35 patients were included. Mean gestational age, birth weight and follow-up were 26.0 weeks, 801g and 4 months, respectively. RD stage was 4A in 24 eyes (47%), 4B in 21 eyes (41%) and 4B/5 in 6 eyes (12%). Forty-three eyes (84%) had prior laser treatment, and 16 eyes (31%) prior intravitreal bevacizumab. Median age at primary Endo-Vit was 44.7 weeks post menstrual age. Median number of surgeries was 1. Bilateral simultaneous surgery was done in 16 patients (46%). Primary retinal re-attachment was 86% overall, 96% in stage 4A, 81% in stage 4B, and 67% in stage 4B/5. None required primary lensectomy. Intraoperative complications occurred in 4 eyes (8%), with 1 lens touch and 3 iatrogenic retinal breaks. Postoperative complications occurred in 2 eyes (4%), with 1 glaucoma and 1 treatment-requiring cataract.
Endoscopic vitrectomy significantly reduces the need for primary lensectomy in high risk traction RD in ROP compared to published outcomes, with favourable anatomic outcomes particularly with earlier intervention.
This is an abstract that was submitted for the 2018 ARVO Annual Meeting, held in Honolulu, Hawaii, April 29 - May 3, 2018.
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