LONG-TERM FUNCTIONAL AND ANATOMICAL OUTCOMES FOLLOWING LENS-SPARING VITRECTOMY FOR ADVANCED RETINOPATHY OF PREMATURITY.

Abstract

To report the long-term functional results following lens-sparing vitrectomy (LSV) in patients with advanced retinopathy of prematurity (ROP). We retrospectively reviewed the records of all patients at a single tertiary referral center who underwent LSV for advanced ROP and were followed for at least 5 years. Baseline demographics, retina status at final visit, need for additional retinal surgery, visual acuity (VA), and complications were recorded. Of 456 eyes of 280 patients who underwent vitreoretinal surgery for advanced ROP, 107 eyes of 79 patients with a mean follow-up of 8.92 ± 3.05 years (range, 5.00-20.05 years) were included. Retinal attachment rates were higher in stage 4A (90.19%) and stage 4B ROP (89.13%) than in eyes with stage 5 ROP (60%). Visual acuity data were available in 52 eyes (48.59%), of which 25 eyes (48.07%) achieved letter-reading vision, whereas 27 eyes (51.93%) had counting fingers, light perception, or no light perception. Favorable VA (≥20/200) was achieved in 53.8% (14/26) of eyes with stage 4A ROP and 16.7% (4/24) of eyes with stage 4B ROP. Among eyes with letter-reading vision, the approximate Snellen VA was 20/100 in stage 4A ROP and 20/209 in stage 4B ROP. None of the eyes with stage 5 ROP achieved letter-reading vision. Glaucoma was the most common complication (26.16%), followed by clinically significant cataract formation (13.08%). LSV preserves letter-reading vision in about half of stage 4A eyes and in one of every six stage 4B eyes. A reattached retina does not guarantee measurable acuity, and no stage 5 eye in this series read letters.