Abstract • Performing vitrectomy in stage 5 retinopathy of prematurity is controversial, partially due to limited anatomical and poor reported visual results. Fifty-five eyes of 50 patients whose retinas were reattached by open-sky vitrectomy in stage 5 retinopathy of prematurity and who were followed up for more than 12 months were analyzed retrospectively to ascertain clinical factors that may influence visual outcome. Vision was evaluated by preferential looking. Visual ability to discriminate stationary objects was obtained in 32 (58.2%) eyes, 18 (32.7%) had motion perception, and five (9.1%) had light stimulus perception. Although visual acuities were relatively low, they were useful to these patients. Age at the time of vitrectomy and the shape of the retinal detachment were found to be important factors in predicting visual prognosis. References 1. Phelps DL. Retinopathy of prematurity: an estimate of vision loss in the United States—1979 . Pediatrics . 1981;67:924-926. 2. Cryotherapy for Retinopathy of Prematurity Cooperative Group. Multicenter trial of cryotherapy for retinopathy of prematurity: three-month outcome . Arch Ophthalmol . 1990;108:195-204.Crossref 3. Topilow HW, Ackerman AL, Wang FM. The treatment of advanced retinopathy of prematurity by cryotherapy and scleral buckling surgery . Ophthalmology . 1985;92:379-387.Crossref 4. McPherson AR, Hittner HM. The scleral buckling in 2.5-11 month old premature infants with retinal detachment associated with acute retrolental fibroplasia . Ophthalmology . 1979;86:819-835.Crossref 5. Greven CM, Tasman W. Scleral buckling in stage 4B and 5 retinopathy of prematurity . Ophthalmology . 1990;97:817-820.Crossref 6. Charles S. Vitreous surgery for retinopathy of prematurity . In: Syllabus: Retinopathy of Prematurity Conference, Washington, DC . Columbus, Ohio: Ross Laboratories; 1981;2:893-902. 7. Machemer R. Closed vitrectomy for severe retrolental fibroplasia in the infant . Ophthalmology . 1983;90:436-441.Crossref 8. Hirose T, Schepens CL. Open-sky vitrectomy in severe retinal detachment caused by advanced retinopathy of prematurity . Ophthalmology . 1984;91( (suppl) ):32. 9. McPherson AR, Hittner HM, Kretzer FL. Retinopathy of Prematurity: Current Concepts and Controversies . Toronto, Ontario: BC Decker;1986:202. 10. Trese MT. Visual results and prognostic factors for vision following surgery for stage V retinopathy of prematurity . Ophthalmology . 1986;92:379-387. 11. Orellana J. Open-sky vitrectomy in stage 5 retinopathy of prematurity . In: Eichenbaum JW, Mamelock A, Mittle RN, Orellana J, eds. Treatment of Retinopathy of Prematurity . St Louis, Mo: Mosby-Year Book; 1990:214-233. 12. Zillis JD, de Juan E, Machemer R. Advanced retinopathy of prematurity: the anatomic and visual results of vitreous surgery . Ophthalmology . 1990;97:821-826.Crossref 13. Quinn GE, Dobson V, Barr CC, et al. Visual acuity in infants after vitrectomy for severe retinopathy of prematurity . Ophthalmology . 1991;98:5-13.Crossref 14. Kalina RE. Treatment of retinal detachment due to retinopathy of prematurity: documented disappointment . Ophthalmology . 1991;98:2-3.Crossref 15. McPherson AR, Hittner HM, Moura RA, Kretzner FL. Treatment of acute retrolental fibroplasia with open-sky vitrectomy . In: McPherson AR, Hittner HM, Kretzner FL, eds. Retinopathy of Prematurity: Current Concepts and Controversies . Toronto, Ontario: BC Decker; 1986:225-234. 16. Tasman W, Borrone RN, Bolling J. Open-sky vitrectomy for total retinal detachment in retinopathy of prematurity . Ophthalmology . 1987;94:449-452.Crossref 17. Katsumi O, Mehta MC, Matsui Y, Tetsuka H, Hirose T. Development of vision in retinopathy of prematurity . Arch Ophthalmol . 1991;109:1394-1398.Crossref 18. International Committee for the Classification of the Late Stages of Retinopathy of Prematurity. An international classification of retinopathy of prematurity . Arch Ophthalmol . 1987;105:906-912.Crossref 19. Hirose T, Schepens CL, Katsumi O, Mehta M. Open-sky vitrectomy in severe retinal detachment caused by advanced retinopathy of prematurity . In: Flynn JT, Tasman W, eds. Retinopathy of Prematurity . New York, NY: Springer-Verlag NY Inc; 1992:95-114. 20. Mayer DL, Dobson V. Visual acuity development in infants and young children as assessed by operant preferential looking . Vision Res . 1982;22:1141-1151.Crossref 21. Wetherhill GB, Levitt H. Sequential estimation of points on a psychometric function . Br J Math Stat Psychol . 1965;18:1-10.Crossref 22. Mayer DL, Fulton AB, Hansen RM. Preferential looking acuity obtained with a staircase procedure in pediatric patients . Invest Ophthalmol Vis Sci . 1982;23:538-543. 23. Birch EE, Hale LA. Criteria for monocular acuity deficit in infancy and early childhood . Invest Ophthalmol Vis Sci . 1988;29:636-643. 24. Duke-Elder S. System of Ophthalmology . London, England: Henry Kimpton; 1967;10:187. 25. Machemer R, Buettner H, Norton E, Parel JM. Vitrectomy: a pars plana approach . Trans Am Acad Ophthalmol Otolaryngol . 1971;75:813. 26. Schepens CL. Clinical and research aspects of subtotal open-sky vitrectomy: XXXVII Edward Jackson Memorial Lectures . Am J Ophthalmol . 1981;91:143-171. 27. Hartnett ME, Gilbert MM, Hirose T, Richardson TM, Katsumi O. Glaucoma as a cause of poor vision in infants with severe retinopathy of prematurity (ROP). Graefes Arch Clin Exp Ophthalmol. In press. 28. Quigley HA, Dunkelberger GR, Green WR. Chronic human glaucoma causing selectively greater loss of large optic nerve fibers . Invest Ophthalmol Vis Sci . 1987;28:913-920. 29. Lucey JF, Dangman B. A reexamination of the role of oxygen in retrolental fibroplasia . Pediatrics . 1984;73:273-277.
Archives of Ophthalmology – American Medical Association
Published: Mar 1, 1993
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