Objective To observe the clinical therapeutic effect of v itrectomy with closed triple incisions on stage 4 or 5 retinopathy of prematurity (ROP). Methods The clinical data of 32 eyes of 26 infants with stage 4 or 5 ROP who un derwent vitrectomy with closed triple incisions from Jan. 2003 to Jan. 2007 were retrospectively analyzed. The 26 infants included 18 males and 8 females, with the gestational age of 27－35 weeks (average 29.4 weeks) and the birth weight of 960－2200 g (average 1434.6 g). The age at the operation was 50-705 days with t he average of 158.3 days. In these 32 eyes, stage 5 ROP was in 13, stage 4 ROP was in 19 (stage 4A in 10 and 4B in 9) in which 11 eyes underwent indirectophthal m oscope photocoagulation because of threshold and type 1 prethreshold ROP and 1 eye underwent cryotherapy again with the disease developing into stage 4 or 5. T he entrance of vitrectomy was closed triple incisions. The lens were saved in 11 eyes and removed in 21 eyes. The followup duration was 2-24 months and the c ondition of retinal reattachment was observed. Results The procedures of operative therapies on 26 affected infants ran smooth. In the 19 eyes at stage 4 ROP, the retina reattached completely in 10 at stage 4A (100%), in which macular traction at optic disc was in 3, remained proliferative membran e in front of the optic disc, in front of the nasal retina and at the peripheral area of the temporal side was found in 4, few vitreous hemorrhage after the ope ration was in 1 which was absorbed 2 weeks later, and cataract after the operati on was in 1; in 9 eyes at stage 4B, retina reattached completely in 6 (66.7%), m acular traction at optic disc was in 1, and retina remained detached in 3 with v itreous hemorrhage after the operation including 2 eyes with anterior chamber he morrhage. In 13 eyes at stage 5, retinal reattached completely in 3 (23.1%) in w hich scars in the peripheral retina, thin retinal vessels and pale optic disc wa s found in 2 and retinal rumple at the temporal side was found in 1; retina reat tached mostly in 1 eye (7.7%) with retinal proliferative membrane and slight re t inal detachment at the nasal side; retina remained detached in 7 eyes. Conclusion Vitrectomy with closed triple incisions for stage 4 ROP may lead the retina l reattachment effectively, but the therapeutic effect is not good on the infant s with stage 5 ROP.
Citation： HUANG Xin,ZHAO Peiquan,SHAN Haidong,et al.. Vitrectomy with closed triple incisions for stage 4 or 5 retinopathy of prem aturity. Chinese Journal of Ocular Fundus Diseases, 2008, 24(1): 9-12. doi: Copy