Anatomical Outcome of 25-Gauge Vitrectomy Associated with Scleral Buckling in Stage 5 Retinopathy of Prematurity: A Case Series Study

Our purpose is to determine the structural outcome of 25-gauge vitrectomy in addition to scleral buckling in stage 5 retinopathy of prematurity (ROP). In a prospective interventional case series, 21 eyes with stage 5 ROP underwent 25-gauge vitrectomy and scleral buckling. Demographic data, disease activity (having plus disease or neovascularization) and the procedure manner were recorded. They were followed 12±2 (range 8-18) months. Anatomical outcomes were assessed during the follow-ups. Success rate was defined as totally reattached retina. In case of vascularly active disease, some eyes received laser therapy or intravitreal bevacizumab before progression to stage 5 ROP. Twenty one eyes of 16 patients with stage 5 ROP with mean gestational age (GA) of 28±2 weeks and birth weight (BW) of 1190± 314 g were included. Lensectomy was done in 81% of eyes. Total reattachment was achieved in 52.3% (success rate) and partial reattachment in 23.8% of the eyes. Reattachments were usually obtained during the first 2-4 weeks. Redetachment occurred in three eyes. Two of them redetached at month 10 and the other one at month 14. Final total reattachment was achieved in 38% of the eyes. Vascularly active disease was seen in 42.8% of the eyes before operation. Success rate was inversely related to disease activity (P=0.044) and directly related to presurgery treatments (P=0.024) [Laser therapy or intravitreal bevacizumab]. The structural outcome of 25-gauge vitrectomy in addition to scleral buckling in stage 5 ROP is promising and vascularly active disease will lower the outcome.