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PREOPERATIVE ANATOMICAL FEATURES ASSOCIATED WITH IMPROVED SURGICAL OUTCOMES FOR STAGE 5 RETINOPATHY OF PREMATURITY
Cemal Ozsaygili1,2, Sengul Ozdek1, Mehmet C Ozmen1
1Ophthalmology Department, Gazi University School of Medicine, Ankara, Turkey.
Insights
Surgery for Stage 5 retinopathy of prematurity (ROP) shows better outcomes in eyes with observable retinal detachment. Preoperative treatment and specific surgical techniques improve success rates in treating this severe ROP stage.
Area of Science:
- Ophthalmology
- Neonatal Care
- Surgical Innovation
Background:
- Stage 5 retinopathy of prematurity (ROP) represents the most advanced form of the disease, often leading to significant visual impairment or blindness.
- Surgical intervention for Stage 5 ROP is challenging due to complex retinal detachment and associated ocular anomalies.
- Understanding preoperative anatomical features is crucial for predicting surgical success in ROP management.
Purpose of the Study:
- To characterize preoperative anatomical features of Stage 5 retinopathy of prematurity (ROP).
- To evaluate surgical outcomes for Stage 5 ROP.
- To identify patient- and surgery-related factors influencing postoperative success.
Main Methods:
- Retrospective analysis of 40 eyes from 33 infants undergoing vitrectomy for Stage 5 ROP.
- Eyes were categorized into groups based on preoperative anatomical features: Group A (observable total retinal detachment) and Group B (funnel retinal detachment with leucocoria).
- Factors analyzed included vascular changes, prior treatment, induced posterior hyaloid detachment, and lens sparing.
Main Results:
- Group A (observable detachment) showed higher anatomical success (55.5%) compared to Group B (15.4%).
- Functional success rates at three years were 33.3% for Group A and 7.7% for Group B.
- Negative impacts on outcomes were associated with vascular dilation/tortuosity and postoperative vitreous hemorrhage; positive effects were linked to preoperative treatment and induced posterior hyaloid detachment.
Conclusions:
- Surgical intervention for observable Stage 5 ROP retinal detachment yields superior anatomical and functional results.
- Preoperative treatment, lens-sparing vitrectomy, and surgically induced posterior hyaloid detachment enhance surgical success in managing Stage 5 ROP.
Purpose:
To describe preoperative anatomical features of Stage 5 retinopathy of prematurity with results of surgery and patient-related and surgery-related factors affecting postoperative success.
Methods:
Forty eyes of 33 infants who underwent vitrectomy with lensectomy or lens-sparing vitrectomy for Stage 5 retinopathy of prematurity were enrolled. Stage 5 cases were divided into different groups according to their preoperative anatomical features as follows: A: for eyes with ophthalmoscopically observable total retinal detachment; B: for eyes with total leucocoria associated with funnel retinal detachment; and C: for eyes with very shallow anterior chamber and corneal opacity. Only A and B eyes underwent surgery. The effect of the presence of vascular dilation and tortuosity, preoperative treatment status, surgically induced posterior hyaloid detachment, and sparing the lens on anatomical and functional results was evaluated.
Results:
Thirty-five percentage of the eyes were in Group A and 65% were in Group B. The mean follow-up was 30.6 months (12-68). Anatomical success was 55.5% for Group A and 15.4% for Group B (P: 0.047), and functional success was 33.3% for Group A and 7.7% for Group B at the third year (P: 0.125). The presence of vascular dilation and tortuosity and postoperative vitreous hemorrhage were found to have negative effects; preoperative treatment and surgical induction of posterior hyaloid detachment were found to have positive effects on anatomical and functional results.
Conclusion:
Surgery for ophthalmoscopically observable retinopathy of prematurity-associated retinal detachment resulted in better anatomical and functional outcomes, and the results are even better in eyes with preoperative treatment, lens-sparing vitrectomy, and surgically induced posterior hyaloid detachment.
