Advanced retinopathy of prematurity. The anatomic and visual results of vitreous surgery.

The anatomic and visual results of vitreous surgery in 140 eyes of 108 children with stage 4 and 5 retinopathy of prematurity (ROP) were reviewed. Macular attachment was achieved in 9 (64%) of 14 eyes with stage 4. In stage 5 eyes, partial posterior attachment was obtained in 38 (31%) of 121 eyes and complete posterior attachment was obtained in 11 eyes (9%). Final visual acuity of fix and follow or greater occurred in 6 (43%) of 14 eyes with stage 4 and in 13 eyes (11%) with stage 5 ROP. Retinal detachment (RD) funnel configurations were classified according to the International Committee on ROP. The funnel type which was wide anteriorly and wide posteriorly had the best anatomic (63%) and visual (19%) success. Reoperation rarely improved visual acuity (4%), although reattachment was possible in 6 (22%) of 27 eyes. All children in this series underwent surgery by 2 years of age. Anatomic and visual success was achieved less often in children who underwent surgery at age 6 months or younger.