Purchase this article with an account.
Carlos A. Abdala, JUAN ESTEBAN UNIGARRO MARTINEZ, Sergio Arrascue, SOFIA VIDAL; Anatomic Success with Lens-Sparing Vitrectomy for Stage 4a Retinopathy of Prematurity. Invest. Ophthalmol. Vis. Sci. 2018;59(9):3765.
Download citation file:
© ARVO (1962-2015); The Authors (2016-present)
To report the results of Lens-sparing vitrectomy in four cases with previous laser photocoagulation and intravitreal Bevacizumab for stage 4a retinopathy of prematurity (ROP4a) in a reference center of Barranquilla,Colombia.
This is a retrospective, consecutive case series. Four eyes of 3 patients with ROP stage 4a were included. The mean gestational age was 29.7 weeks (29-32 weeks). The average birth weight was 1155 g (1000-1220 g). Oxygen therapy and blood transfusion were found as risk factors in all patients and 3/4 cases had sepsis and respiratory distress syndrome. Only one patient had a perinatal surgery for hidrocefalia. Postconceptional age at vitrectomy was 40.5 weeks (36-46 weeks). Three eyes received previous laser photocoagulation combined with intravitreal Bevacizumab and only 1 eye received laser photocoagulation alone. Vitrectomies were performed by the same surgeon (CAC) with 25G instruments, sclerotomies were placed at 1.5 mm posterior to the limbus for a 3 port approach, a lens-sparing vitrectomy technique and another intravitreal Bevacizumab at the end of the surgery were performed in all cases. One patient underwent a simultaneous and bilateral surgery for ROP4a in both eyes.
The mean follow-up was 3.2 months (2-6 months). None of the cases developed signs of infection or cataract. In 3/4 eyes (75%) releasing of traction, reapplication of the retina and anatomic success were obtained. Two eyes from the same patient developed hemovitreous in the immediate postopoperative period that resolved spontaneously at two months. One of these eye progressed to stage 5 ROP. In the others three eyes retina remains attached.
These results shows that lens-sparing, unilateral or simultaneously bilateral, vitrectomy in ROP 4a is a feasible and safe procedure when retinal traction is present and neovascular proliferation activity is in a regression phase previously treated with laser alone or in combination with anti-VEGF. We need further studies with larger number of cases and a long-term follow up to support our findings and determine late complications in this population.
This is an abstract that was submitted for the 2018 ARVO Annual Meeting, held in Honolulu, Hawaii, April 29 - May 3, 2018.
This PDF is available to Subscribers Only