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Posterior hyaloid peeling in advanced stages of aggressive posterior ROP
1Faculty of Medicine, Department of Ophthalmology, Semmelweis University Budapest, Budapest, Hungary. ecsedy@yahoo.co.uk
Insights
Early lens-sparing vitrectomy for aggressive posterior retinopathy of prematurity (ROP) is advantageous. This intervention, performed between 37-40 weeks, can halt disease progression in infants with ROP.
Area of Science:
- Ophthalmology
- Neonatology
- Pediatric Surgery
Background:
- Aggressive posterior retinopathy of prematurity (ROP) is a severe condition requiring timely intervention.
- Early surgical management aims to prevent vision loss in affected infants.
Purpose of the Study:
- To determine the optimal indications and timing for surgical intervention in aggressive posterior ROP.
- To evaluate the outcomes of early lens-sparing vitrectomy in this patient population.
Main Methods:
- Retrospective review of 9 eyes from 7 children with aggressive posterior ROP.
- Analysis of preoperative findings, surgical procedures, and postoperative outcomes, including anatomic status and visual fixation at 1 year.
- Focus on early lens-sparing vitrectomy with posterior hyaloid peeling.
Main Results:
- Indications for surgery included vitreous hemorrhage and recurrent plus disease with retinal detachment.
- Vitrectomy was performed between 37 and 44 postmenstrual weeks (mean 40 weeks).
- Disease progression was halted in 7 eyes, with successful peeling of the posterior hyaloid and proliferative tissue.
Conclusions:
- Lens-sparing vitrectomy with posterior hyaloid peeling is beneficial in infants with aggressive posterior ROP at early postmenstrual ages (37-40 weeks).
- Formation of a gliotic membrane anterior to the lens was associated with unfavorable outcomes.
Purpose:
To evaluate the indications and timing of surgical intervention on eyes with aggressive posterior retinopathy of prematurity (ROP).
Methods:
Retrospective review of a consecutive case series of 9 eyes of 7 children, with aggressive posterior ROP, who underwent early lens-sparing vitrectomy. Preoperative retinal and vitreal features, intraoperative and postoperative complications, postoperative anatomic status, and fixation behavior 1 year after surgery were investigated.
Results:
Vitreous hemorrhage and recurrence of plus disease with retinal detachment were the main indications for surgery. Vitrectomy was performed from the 37th to the 44th postmenstrual week (mean 40th week). In 7 eyes, vitrectomy could stop the disease progression. In all of these cases, posterior hyaloid could be peeled together with the proliferative tissue.
Conclusions:
Lens-sparing vitrectomy with posterior hyaloid peeling at early postmenstrual ages (37-40 postmenstrual weeks) seems to be advantageous in infants with aggressive posterior ROP. The formation of a gliotic membrane growing ahead to the posterior surface of the lens resulted in unfavorable outcomes in our cases.
