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Ophthalmology. 2015 Apr;122(4):755-9. doi: 10.1016/j.ophtha.2014.11.004. Epub 2015 Jan 15.

Long-term outcomes on lens clarity after lens-sparing vitrectomy for retinopathy of prematurity.

Author information

1
Department of Ophthalmology, Shiley Eye Center and Jacobs Retina Center, University of California, San Diego, La Jolla, California.
2
Department of Ophthalmology, Emory Eye Center, Emory University, Atlanta, Georgia.
3
Associated Retinal Consultants, P.C. Royal Oak, Michigan.
4
Associated Retinal Consultants, P.C. Royal Oak, Michigan; Department of Ophthalmology, William Beaumont Hospital, Royal Oak, Michigan.
5
Associated Retinal Consultants, P.C. Royal Oak, Michigan; Department of Ophthalmology, William Beaumont Hospital, Royal Oak, Michigan. Electronic address: mgjt46@aol.com.

Abstract

OBJECTIVE:

To describe the long-term effect of lens-sparing vitrectomy surgery for advanced retinopathy of prematurity (ROP) on lens clarity.

DESIGN:

Retrospective case series at a single tertiary referral pediatric vitreoretinal practice.

PARTICIPANTS:

Four hundred ninety-six eyes from 351 patients were included.

METHODS:

A retrospective chart review was conducted of patients with diagnosis of ROP stage 4A, 4B, and 5 who underwent lens-sparing vitrectomy (LSV) between 1992 and 2013. Data were collected from patient charts, including gender, date of birth, gestational age at birth, birthweight, stage of ROP at presentation, initial treatment (laser or cryotherapy), date of LSV, date of lensectomy (if performed), lens status at time of lensectomy, date of last visit, lens status at last visit, subsequent retinal surgeries, and retinal attachment status at last visit. Patients were excluded if any surgery had been performed at an outside institution before referral, or if a scleral buckle had been placed. Eyes with a concurrent anatomic abnormality, such as coloboma or microcornea, or a known family history of familial exudative vitreoretinopathy (FEVR), were also excluded.

MAIN OUTCOME MEASURES:

Retinal reattachment after LSV, lensectomy after LSV, lens opacity at the time of lensectomy, and lens clarity at last follow-up.

RESULTS:

Four hundred ninety-six eyes from 351 patients met inclusion criteria for this study. The reattachment rate after a single LSV surgery was 82.1% for stage 4A, 69.5% for stage 4B, and 42.6% for stage 5. Subsequent retinal surgeries were required in 19.8% of eyes, with 88.7% of them including a lensectomy. Among eyes requiring lensectomy, 75% occurred within the first year after LSV surgery. Lens opacities were present in 26.6% of eyes at the time of lensectomy. Of all eyes in this series, 5.9% required lensectomy because of lens opacity.

CONCLUSIONS:

This study demonstrates that lens clarity is observed in most eyes after LSV surgery for advanced ROP for the patient's childhood. Within the first decade of life, if necessary, lensectomy after LSV occurred mostly within 1 year following LSV.

PMID:
25600197
DOI:
10.1016/j.ophtha.2014.11.004
[Indexed for MEDLINE]

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