Purpose: To assess long-term functional results after vitrectomy for stages 4 and 5 retinopathy of prematurity (ROP).
Methods: Retrospective analysis of data from eyes that underwent lens-sparing vitrectomy (LSV) or combined lensectomy and vitrectomy (LV) and had a follow-up of at least 5 years.
Results: Eighty-eight eyes of 65 infants who underwent LSV or LV for stage 4 or 5 ROP were included in the study. The mean follow-up was 6.9 years. The anatomic success rate was 89% (17/19) for stage 4A, 63% (24/38) for stage 4B, and 42% (13/31) for stage 5. Forty-five eyes (51%) had measurable visual acuity (VA). The approximate Snellen VA equivalent was 20/550 for stage 4A, 20/1600 for stage 4B, and 20/4000 for stage 5. The remaining 39% (34/88) had light perception or no light perception. Owing to neurological conditions, VA in nine eyes (10%) could not be measured. Anatomic and visual outcomes were not associated with surgical technique.
Conclusions: Surgery for stage 4A ROP has better visual success. Acceptable vision for stage 4B and poor for stage 5 ROP, despite retinal reattachment, is thought to be secondary to irreversible injury to either the retina or visual nervous pathways, or both.
Keywords: Retina; Treatment Surgery; Vision.
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