Surgical results and visual outcomes of vitreous surgery for advanced stages of retinopathy of prematurity.

PURPOSE We evaluated the effectiveness of vitreous surgery for advanced stages of retinopathy of prematurity (ROP) with traction retinal detachment. METHODS Vitreous surgery was performed in 34 children (51 eyes) with total traction retinal detachment associated with stage 5 ROP between January 1989 and December 1991 at the Fukuoka University Hospital. The first phase of the procedure was composed of pars plicata lensectomy, followed by vitrectomy, membrane delamination, and hyaluronic acid injection. For unsuccessful cases, the second phase of the procedure, comprising scleral encircling, vitrectomy, membrane delamination, retinotomy fluid-air exchange, and SF6 or temporary silicone injection with endophotocoagulation, was performed. In cases with surgical success, visual acuity was measured using the Landolt ring test. RESULTS Of the 33 eyes with unsuccessful phase 1 surgery, 15 underwent the second phase procedure. Retinal reattachment was achieved in 7 of these 15 eyes (46.7%). Our composite rate of successful retinal reattachment for advanced stages of ROP was 47% (24 of 51 eyes). In 15 of the 24 eyes with surgical success, visual acuity was more than 20/600 in 3 eyes and no light perception in 1 eye. CONCLUSION In vitreous surgery for advanced stages of ROP, retinal breaks and vitreous hemorrhage are important factors leading to surgical failure. In this series, we could achieve visual acuity of more than light perception for several cases.