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Visual outcomes after lens-sparing vitrectomy for stage 4A retinopathy of prematurity
Jonathan L Prenner1, Antonio Capone, Michael T Trese
1Pediatric Retina Service, Associated Retinal Consultants, William Beaumont Hospital, Royal Oak, Michigan, USA.
Insights
Lens-sparing pars plana vitrectomy (PPV) successfully reattaches the retina in children with stage 4A retinopathy of prematurity (ROP) retinal detachments (RDs). This treatment also leads to favorable visual outcomes for these complex pediatric cases.
Area of Science:
- Ophthalmology
- Pediatric Retina Surgery
- Retinopathy of Prematurity
Background:
- Retinopathy of prematurity (ROP) is a leading cause of childhood blindness.
- Stage 4A retinal detachment (RD) in ROP presents significant surgical challenges.
- Previous treatments for severe ROP have variable visual outcomes.
Purpose of the Study:
- To evaluate the visual results of treating stage 4A RDs in retinopathy of prematurity (ROP).
- To assess the efficacy of lens-sparing pars plana vitrectomy (PPV) in these cases.
Main Methods:
- Retrospective case series of 45 eyes from 39 children with stage 4A RDs due to ROP.
- All patients underwent lens-sparing pars plana vitrectomy (PPV) with membrane peeling.
- Anatomic success was confirmed by ophthalmoscopy; visual acuity (VA) was measured using Teller or Allen charts.
Main Results:
- Successful retinal reattachment was achieved in all 23 eyes with formal VA testing.
- The macula was normal in 83% of eyes.
- The average logarithm of the minimum angle of resolution VA was 20/58, with most eyes achieving 20/80 or better.
Conclusions:
- Lens-sparing PPV is an effective surgical approach for stage 4A RDs in ROP.
- This technique offers favorable anatomic and visual outcomes.
- It provides a viable treatment option for complex pediatric retinal detachments.
Purpose:
To assess the visual outcomes of patients with stage 4A retinal detachments (RDs) from retinopathy of prematurity (ROP).
Design:
Retrospective review of a consecutive case series of children referred to the pediatric retina service of Associated Retinal Consultants, Royal Oak, Michigan.
Participants:
Forty-five eyes of 39 children.
Methods:
The stage of RD for each patient was determined during an examination under anesthesia. All patients underwent a lens-sparing pars plana vitrectomy (PPV) with membrane peeling. Postoperative anatomic status was determined by ophthalmoscopy either during an office examination or during an examination under anesthesia. Visual outcomes were ascertained by consulting pediatric ophthalmologists using either Teller or Allen acuities.
Main Outcome Measures:
Anatomic and visual outcomes.
Results:
Formalized visual acuity (VA) measurement was performed in 23 eyes of 20 children, and was not performed in 22 eyes of 19 children. All 23 eyes that were formally tested had successful retinal reattachment. The macula appeared to be normal and without distortion in 19 of 23 eyes (83%) during the follow-up period. Average logarithm of the minimum angle of resolution VA was 20/58. Three eyes had acuities of 20/200, and 4 had acuities of 20/100. All other eyes were 20/80 or better. Average age at time of VA was 3.51 years.
Conclusions:
Patients with ROP and stage 4A RDs can be treated successfully with respect to anatomic and visual outcome utilizing lens-sparing PPV.
