PREOPERATIVE ANATOMICAL FEATURES ASSOCIATED WITH IMPROVED SURGICAL OUTCOMES FOR STAGE 5 RETINOPATHY OF PREMATURITY.

Abstract

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. 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. 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. 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.