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Functional and anatomical outcomes after primary lens-sparing pars plana vitrectomy for Stage 4 retinopathy of prematurity.

Bhende P, Gopal L, Sharma T, Verma A, Biswas RK - Indian J Ophthalmol (2009 Jul-Aug)

Bottom Line: At mean follow-up of 15 months, 74% of the eyes had a favorable anatomical outcome with single procedure.The visual status was favorable in 63% .Intraoperative complications included vitreous hemorrhage, pre-retinal hemorrhage and retinal break formation.

View Article: PubMed Central - PubMed

Affiliation: Sri Bhagwan Mahaveer Vitreoretinal Services, Medical and Vision Research Foundations, Sankara Nethralaya, 18 College Road, Chennai, India. pramod1999@yahoo.com

ABSTRACT

Background: While lens-sacrificing vitrectomy is the standard approach to manage Stage 5 retinopathy of prematurity (ROP), scleral buckling has been used to manage some cases of Stage 4. Lens-sparing vitrectomy was popularized by Maguire and Trese in selected cases of Stage 4 disease.

Purpose: To assess the functional and visual outcomes after primary lens-sparing pars plana vitrectomy for Stage 4 ROP.

Materials and methods: In a retrospective, interventional, consecutive case series, the records of 39 eyes of 31 patients presenting with Stage 4 retinal detachment secondary to ROP who underwent primary two or three-port lens-sparing vitrectomy from January 2000 to October 2006 were evaluated. The outcomes studied at the final follow-up visit were the retinal status, lens and medial clarity and visual acuity . Favorable anatomical outcome was defined as the retinal reattachment of the posterior pole at two months after the surgery; and favorable functional outcome was defined as a central, steady and maintained fixation, with the child following light.

Results: At mean follow-up of 15 months, 74% of the eyes had a favorable anatomical outcome with single procedure. The visual status was favorable in 63% . The lens remained clear in all the eyes at the last follow-up, and the media clarity was maintained in 87%. Intraoperative complications included vitreous hemorrhage, pre-retinal hemorrhage and retinal break formation.

Conclusions: Lens-sparing vitrectomy helps to achieve a favorable anatomical and functional outcome in selected cases of Stage 4 ROP.

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Related in: MedlinePlus

(a) Preoperative fundus photograph showing fibrovascular proliferation (FVP) and focal tractional detachment involving posterior pole (arrow). Note the well-ablated peripheral retina (b) Corresponding postoperative fundus photo of the same patient. Note the trimmed FVP at the disc with radiating dry retinal folds (arrow)
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Figure 0001: (a) Preoperative fundus photograph showing fibrovascular proliferation (FVP) and focal tractional detachment involving posterior pole (arrow). Note the well-ablated peripheral retina (b) Corresponding postoperative fundus photo of the same patient. Note the trimmed FVP at the disc with radiating dry retinal folds (arrow)

Mentions: The mean follow-up period was 15 months (range 2–55 months). One patient (Stage 4a) was lost to follow-up after the surgery. At the follow-up examination, 28 of 38 eyes (74%) achieved a complete or posterior pole retinal reattachment with one procedure [Figures 1a and b]. These included 23 eyes (82%) with Stage 4a ROP and five eyes of Stage 4b ROP. Lens clarity was maintained in all eyes.


Functional and anatomical outcomes after primary lens-sparing pars plana vitrectomy for Stage 4 retinopathy of prematurity.

Bhende P, Gopal L, Sharma T, Verma A, Biswas RK - Indian J Ophthalmol (2009 Jul-Aug)

(a) Preoperative fundus photograph showing fibrovascular proliferation (FVP) and focal tractional detachment involving posterior pole (arrow). Note the well-ablated peripheral retina (b) Corresponding postoperative fundus photo of the same patient. Note the trimmed FVP at the disc with radiating dry retinal folds (arrow)
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC2712694&req=5

Figure 0001: (a) Preoperative fundus photograph showing fibrovascular proliferation (FVP) and focal tractional detachment involving posterior pole (arrow). Note the well-ablated peripheral retina (b) Corresponding postoperative fundus photo of the same patient. Note the trimmed FVP at the disc with radiating dry retinal folds (arrow)
Mentions: The mean follow-up period was 15 months (range 2–55 months). One patient (Stage 4a) was lost to follow-up after the surgery. At the follow-up examination, 28 of 38 eyes (74%) achieved a complete or posterior pole retinal reattachment with one procedure [Figures 1a and b]. These included 23 eyes (82%) with Stage 4a ROP and five eyes of Stage 4b ROP. Lens clarity was maintained in all eyes.

Bottom Line: At mean follow-up of 15 months, 74% of the eyes had a favorable anatomical outcome with single procedure.The visual status was favorable in 63% .Intraoperative complications included vitreous hemorrhage, pre-retinal hemorrhage and retinal break formation.

View Article: PubMed Central - PubMed

Affiliation: Sri Bhagwan Mahaveer Vitreoretinal Services, Medical and Vision Research Foundations, Sankara Nethralaya, 18 College Road, Chennai, India. pramod1999@yahoo.com

ABSTRACT

Background: While lens-sacrificing vitrectomy is the standard approach to manage Stage 5 retinopathy of prematurity (ROP), scleral buckling has been used to manage some cases of Stage 4. Lens-sparing vitrectomy was popularized by Maguire and Trese in selected cases of Stage 4 disease.

Purpose: To assess the functional and visual outcomes after primary lens-sparing pars plana vitrectomy for Stage 4 ROP.

Materials and methods: In a retrospective, interventional, consecutive case series, the records of 39 eyes of 31 patients presenting with Stage 4 retinal detachment secondary to ROP who underwent primary two or three-port lens-sparing vitrectomy from January 2000 to October 2006 were evaluated. The outcomes studied at the final follow-up visit were the retinal status, lens and medial clarity and visual acuity . Favorable anatomical outcome was defined as the retinal reattachment of the posterior pole at two months after the surgery; and favorable functional outcome was defined as a central, steady and maintained fixation, with the child following light.

Results: At mean follow-up of 15 months, 74% of the eyes had a favorable anatomical outcome with single procedure. The visual status was favorable in 63% . The lens remained clear in all the eyes at the last follow-up, and the media clarity was maintained in 87%. Intraoperative complications included vitreous hemorrhage, pre-retinal hemorrhage and retinal break formation.

Conclusions: Lens-sparing vitrectomy helps to achieve a favorable anatomical and functional outcome in selected cases of Stage 4 ROP.

Show MeSH
Related in: MedlinePlus