Lens-sparing vitrectomy for progressive tractional retinal detachments associated with stage 4A retinopathy of prematurity

Objective: To describe the results of lens-sparing vitrectomy in infants with progressive, fovea-threatening, tractional retinal detachments associated with stage 4A retinopathy of prematurity. Methods: In a retrospective, interventional, consecutive clinical case series, the records of patients with stage 4A retinopathy of prematurity who underwent lens-sparing vitrectomy for progressive retinal detachments were reviewed. Retinal attachment status, reversed or arrested retinal dragging, and visual acuity were assessed after the procedure. Results: Thirty-two eyes of 29 patients underwent lens-sparing vitrectomy at a mean postconceptional age of 43 weeks. Thirty (94%) of 32 eyes had complete retinal reattachment and arrest or reversal of retinal dragging after 1 lens-sparing vitrectomy. Visual acuity of at least central, steady, and unmaintained was observed in 17 (81%) of the 21 eyes in which it was tested and at least central, steady, and maintained vision was measured in 13 (62%) of 21 eyes, with 1 eye achieving 20/40 visual acuity. Conclusions: Lens-sparing vitrectomy is a safe and effective procedure for the treatment of fovea-threatening retinal detachments in patients with stage 4A retinopathy of prematurity.