Abstract
Purpose :
To evaluate the safety and efficacy of endoscopic vitrectomy (Endo-Vit) for stage 4 retinopathy of prematurity (ROP)
Methods :
Consecutive non-comparative case series of surgery of all UK cases for traction RD in ROP (stage 4) between 2015-2021. Inclusion criteria was stage 4A or 4B ROP. Stage 5 cases were excluded. All cases had primary simultaneous high-resolution 19 gauge endoscopy and microscope-based visualisation, with standard 23 gauge vitrectomy
Results :
Included were 99 eyes of 57 patients. Mean gestational age, birth weight and follow-up were 25.9 weeks, 789g and 27.4 months, respectively. RD stage was 4A in 54 eyes, 4B in 34 eyes and 4B/5 in 11 eyes. Prior laser was done in 84%, and intravitreal bevacizumab in 28%. Median number of surgeries was 1. Primary retinal re-attachment was 82% overall, 90% in stage 4A, 85% in stage 4B, and 36% in stage 4B/5. Primary lensectomy was required in 0%. Iatrogenic break occurred in 4 eyes. Postoperative cataract occurred in 4 eyes, all of whom developed 12 months after surgery. Visual acuity data was available in 92%, with overall fix and follow vision in 71%, logMAR 2.0 or better in 52%, and logMAR 1.0 or better in 29%.
Conclusions :
Endoscopic visualisation significantly reduces the need for primary lensectomy in complex traction retinal detachment in retinopathy of prematurity, with favourable anatomic outcomes. It is a useful adjunct to microscope-based visualisation.
This abstract was presented at the 2022 ARVO Annual Meeting, held in Denver, CO, May 1-4, 2022, and virtually.