Anatomic success of lens-sparing vitrectomy with and without scleral buckle for stage 4 retinopathy of prematurity

PURPOSE: To compare the anatomic outcomes of lens-sparing vitrectomy (LSV) with those of combined LSV and scleral buckle (SB) in surgical repair of retinopathy of prematurity (ROP) stage 4 retinal detachment. DESIGN: Retrospective, interventional, consecutive case series. METHODS: Twenty-one eyes of 15 patients with stage 4 ROP detachment were enrolled. All patients were selected from consecutive patients with stage 4 ROP detachment treated with LSV alone or combined LSV and SB. Patient characteristics, including gestational age, birth weight, gender, corrected gestational age at time of surgery, surgical procedure, anatomic outcome, ability to fix and follow, and progression of cataract or glaucoma were recorded. RESULTS: Twelve of 21 eyes underwent the combined procedure (LSV with SB), and the remaining nine eyes underwent LSV alone. Eighteen (86%) of 21 eyes achieved retinal reattachment overall, with seven (87%) of eight stage 4B detachments repaired in one surgery. Eleven (85%) of 13 stage 4A detachments were repaired in one surgery. Of the patients in whom treatment failed, two were in the LSV with SB group (2/12; 16%) and one was in the LSV alone group (1/9; 11 %). CONCLUSIONS: The data suggest that SB adds little to the success or failure of LSV and therefore is an unnecessary adjunct to LSV for stage 4 ROP.