Immediate Sequential Bilateral Vitrectomy Surgery for Retinopathy of Prematurity: A Single Surgeon Experience

• Published in: Turk oftalmoloji gazetesi Vol. 51; no. 4; pp. 225 - 230
• Main Authors: Özdek, Şengül, Özmen, Mehmet Cüneyt, Yalınbaş, Duygu, Atalay, Hatice Tuba, Coşkun, Demet
• Format: Journal Article
• Language: English
• Published: Turkey Galenos Yayinevi Tic. Ltd 01-08-2021; Türk Oftalmoloji Derneği; Galenos Publishing; Galenos Yayinevi
• Subjects: Child, Preschool; Development and progression; Follow-Up Studies; Humans; Infant; Infant, Newborn; Infants; Original; Patient compliance; Remifentanil; retinopathy of prematurity; Retinopathy of Prematurity - surgery; Retrolental fibroplasia; Retrospective Studies; sequential bilateral surgery; Surgeons; Tıp; Treatment Outcome; Visual Acuity; Vitrectomy; İstanbul; Türkiye; sequential bilateral surgery; Retinopathy of prematurity; vitrectomy
• ISSN: 1300-0659; 2149-8695; 2149-8709; 2147-2661
• DOI: 10.4274/tjo.galenos.2020.07377

We report the safety and efficacy of simultaneous bilateral vitrectomy for stage 4 and stage 5 retinopathy of prematurity (ROP).
Babies who had immediate sequential bilateral vitrectomy surgery for stage 4 or stage 5 ROP were included in this retrospective study. Clinical history, demographic characteristics of the patients, surgical procedure details, perioperative and postoperative ophthalmic and systemic complications, and postoperative anatomical success rates were evaluated. General anesthesia features were also recorded.
Seventy eyes of 35 babies who had immediate sequential bilateral vitrectomy surgery for stage 4 or stage 5 ROP were reviewed. At the time of surgery, the mean age was 41.4±4.9 weeks. There was preoperative plus disease in 58.6% of the eyes. The mean surgery/eye ratio was 1.2. Mean anesthesia time was 95±64 minutes. The mean follow-up was 28.1 months (3 to 84 months). Anatomical success was 95.7% for stage 4A (44/46 eyes), 83.3% for stage 4B (15/18 eyes), and 50% for stage 5 (3/6 eyes) ROP. Patients with stage 5 ROP had significantly less anatomical success than stage 4A and 4B (p=0.004). None of the patients had endophthalmitis and anesthesia-related severe complications.
Immediate sequential bilateral vitrectomy surgery can be considered an option for patients with active bilateral stage 4 and stage 5 ROP. The risk of endophthalmitis should be weighed against the risks of disease progression and anesthesia-related complications.