LONG-TERM FUNCTIONAL AND ANATOMICAL OUTCOMES FOLLOWING LENS-SPARING VITRECTOMY FOR ADVANCED RETINOPATHY OF PREMATURITY

PURPOSE: To report the long-term functional results following lens-sparing vitrectomy (LSV) in patients with advanced retinopathy of prematurity (ROP). METHODS: We retrospectively reviewed the records of all patients at a single tertiary referral center who underwent LSV for advanced ROP and were followed for at least 5 years. Baseline demographics, retina status at final visit, need for additional retinal surgery, visual acuity (VA), and complications were recorded. RESULTS: Of 456 eyes of 280 patients who underwent vitreoretinal surgery for advanced ROP, 107 eyes of 79 patients with a mean follow-up of 8.92 ± 3.05 years (range, 5.00-20.05 years) were included. Retinal attachment rates were higher in stage 4A (90.19%) and stage 4B ROP (89.13%) than in eyes with stage 5 ROP (60%). Visual acuity data were available in 52 eyes (48.59%), of which 25 eyes (48.07%) achieved letter-reading vision, whereas 27 eyes (51.93%) had counting fingers, light perception, or no light perception. Favorable VA (≥20/200) was achieved in 53.8% (14/26) of eyes with stage 4A ROP and 16.7% (4/24) of eyes with stage 4B ROP. Among eyes with letter-reading vision, the approximate Snellen VA was 20/100 in stage 4A ROP and 20/209 in stage 4B ROP. None of the eyes with stage 5 ROP achieved letter-reading vision. Glaucoma was the most common complication (26.16%), followed by clinically significant cataract formation (13.08%). CONCLUSIONS: LSV preserves letter-reading vision in about half of stage 4A eyes and in one of every six stage 4B eyes. A reattached retina does not guarantee measurable acuity, and no stage 5 eye in this series read letters.