Journal Article

Long-term surgical outcomes and prognostic factors for advanced-stage retinopathy of prematurity after vitrectomy

Liu, Laura, Lai, Chi-Chun, Chen, Kuan-Jen, Wu, Wei-Chi, Wang, Nan-Kai, Hwang, Yih-Shiou, Kang, Eugene Yu-Chuan, Chang, Yin-Hsi

2025

Overview

Background/aimsThe aims of this study is to evaluate the anatomic, visual outcomes and associated prognostic factors in patients with advanced retinopathy of prematurity (ROP) following vitrectomy.MethodsA retrospective cohort study of patients with ROP who underwent vitrectomy from 2005 to 2016 was conducted. All the patients had a follow-up period of at least 5 years. Univariate and multivariable logistic regression analyses were used to explore the factors related to unfavourable outcomes.ResultsIn total, 81 eyes of 51 patients were included. The mean age at last follow-up was 10.2 years. The anatomic success rate was 96.3% (26/27) for stage 4A, 90.9% (20/22) for stage 4B and 31.3% (10/32) for stage 5 ROP (p<0.01). The mean logMAR best corrected visual acuity of the stage-4A eyes was the highest, followed by those of stage-4B and stage-5 eyes (0.8, 1.5 and 2.6 for stages 4A, 4B and 5, respectively; p<0.01). High myopia (≤ −5.0 D) was noted in 70.8% and 71.4% of stage-4A and stage-4B eyes, respectively. Cataract was the most common complication (25.9%), followed by corneal opacity (17.3%), strabismus (16.1%), and phthisis (16.1%). Stage of the disease was a poor prognostic factor in all vitrectomised eyes (p<0.01). Vitrectomy combined lensectomy was a significant predictor for poor anatomic outcomes for stage-4 eyes (p=0.03). Presence of plus disease was also a possible factor affecting the surgical outcomes.ConclusionThe long-term surgical outcomes of the eyes with stage 4A and 4B ROP were favourable. Management of stage 5 ROP remained challenging.

• Publisher: BMJ Publishing Group Ltd,BMJ Publishing Group LTD
• Subject: Adolescence / Adolescent / Age / Anatomy / Astigmatism / Birth weight / Child / Child development / Child health (paediatrics) / Child, Preschool / Childhood / Female / Follow-Up Studies / Gestational Age / Humans / Infant, Newborn / Lasers / Male / Medical prognosis / Medical records / Patients / Prognosis / Regression analysis / Retina / Retinal detachment / Retinopathy of Prematurity - diagnosis / Retinopathy of Prematurity - surgery / Retrospective Studies / Silicones / Statistical analysis / Surgeons / Surgery / Surgical outcomes / Time Factors / Treatment Outcome / Treatment Surgery / Vascular endothelial growth factor / Vision / Visual acuity / Visual Acuity - physiology / Vitrectomy / Vitreoretinal surgery