Surgical management for stage 5 retinopathy of prematurity

To determine the prognosis of advanced retinopathy of prematurity (ROP) after surgery, we reviewed retrospectively the results of vitrectomy performed between November 1987 and December 1993 in 38 eyes with stage 5 ROP. The patients' mean age at surgery was 11 months, mean follow-up period was 24.1 months. Anatomical success, defined as reattachment of posterior pole retina, was achieved in 11 eyes (29.0%) and functional success, defined as presence of fixation and following was achieved in 7 eyes (18.4%). Anatomical success was well correlated with preoperative configuration of retina, i.e. open-funnel type showed better results than closed-funnel type (44.4% compared to 15.0%). There were no differences between anatomical success and failure group according to gestational age, birth weight, age at the time of diagnosis of ROP, chronological and postconceptional age, and body weight at the time of surgery. For good prognosis, it is necessary to operate early in stage 5 ROP when retinal funnel is still open.