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Published on: January 11, 2016
Follow-up of 15 children with severe ROP 1987-1989
S Crafoord1, I Stenström, J Schollin
1Department of Ophthalmology, Orebro Medical Center Hospital, Sweden.
Insights
Surgical interventions for severe retinopathy of prematurity (ROP) successfully reattached retinas in stages 3+ and 4B. Stage 5 ROP showed limited success with retinal reattachment and visual outcomes.
Area of Science:
- Ophthalmology
- Neonatal Medicine
- Surgical Innovation
Background:
- Severe retinopathy of prematurity (ROP) poses a significant risk to infant vision.
- Early intervention is crucial for managing advanced stages of ROP.
Purpose of the Study:
- To evaluate the surgical outcomes of treating severe retinopathy of prematurity (ROP) in premature infants.
- To assess the efficacy of cryotherapy, buckling procedures, and vitreous surgery in ROP management.
Main Methods:
- Retrospective analysis of 15 premature infants with severe ROP (stages 3+, 4B, 5) treated between 1987-1989.
- Surgical interventions included cryotherapy for stage 3+ and buckling/vitreous surgery for stages 4B and 5.
- Follow-up ranged from 2 to 5.5 years to assess retinal reattachment and visual acuity.
Main Results:
- Complete retinal reattachment was achieved in all stage 3+ and 4B eyes post-surgery.
- Four out of seventeen stage 5 ROP eyes achieved central retinal reattachment.
- Visual acuity was measurable in all treated stage 3+ and 4B eyes; only two stage 5 eyes with reattached retinas had light perception.
Conclusions:
- Surgical treatment for stage 3+ and 4B ROP demonstrated high success rates for retinal reattachment.
- Outcomes for stage 5 ROP were less favorable, with limited retinal reattachment and poor visual prognosis.
- Early surgical intervention in ROP is vital, but advanced stages present significant challenges.
Abstract:
Between 1987-89 fifteen premature infants with severe retinopathy of prematurity (ROP), at the age of ten months or less, were admitted as outpatients to the Department of Ophthalmology at the Orebro Medical Center Hospital. Initial examination of the infants showed that 6 eyes had stage 3+, 3 eyes had stage 4B and 21 eyes had stage 5 ROP. All 15 infants were born at gestational week 24-28 (mean value 26) and had a birth weight between 600 and 1310 g (mean 907 g). For stage 3+ cryotherapy was performed. For stage 4B and 5 buckling procedure and vitreous surgery was performed in an attempt to re-attach the retina. The children were followed 2-5.5 years. Postoperatively, the retinas of all eyes in stage 3+ and 4B were attached. Four retinas out of seventeen stage 5 eyes were later found to be centrally re-attached. One eye with stage 3+ and four eyes with stage 5 were not treated at all. At follow-up of stage 3+ and 4B, visual acuity was measurable in all eyes; in stage 5 only two out of four eyes with anatomically reattached retinas had perception of light.
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