Gopal Lingam, Bhende Pramod, Rao Chetan, Sen Parveen, Sharma Tarun, Dasgupta Debarati
Department of Vitreo Retinal Services, Medical Research Foundation, Chennai, Tamil Nadu, India.
Department of Ophthalmology, National University Hospital, Singapore.
Indian J Ophthalmol. 2025 Jan 1;73(Suppl 1):S132-S138. doi: 10.4103/IJO.IJO_179_24. Epub 2024 Sep 10.
To report the long-term anatomical and functional results of lens-sparing vitrectomy (LSV) for stage 4 retinopathy of prematurity (ROP).
Retrospective study.
This is a study of 23 eyes of 16 patients with stage 4 ROP who underwent lens-sparing vitrectomy at a tertiary care center and had a minimum of 2 years of follow-up. The main outcome measures are the retinal status and visual outcome at the final follow-up.
After a mean follow-up of 7.36 years, the lenses remained clear in 69.57%; anatomical success in terms of the attached retina was achieved in 19/23 eyes (82.61%) and vision of ≥6/24 was achieved in 8/23 eyes (34.78%), whereas navigational vision (≥1/60) was achieved in 16/23 (69.56%). The mean spherical equivalent was -8.50 + 6.39 diopters. High myopia (≥7 dsph) was noted in 43.47% of patients. The severity of myopia was not related to previous lasers and was less severe in eyes with posterior pole residual folds compared to normalized fundus or eyes with macular drag but no fold. At the final follow-up, 3/16 (18.75%) patients had bilateral blindness due to total retinal detachments and 11/16 (68.75%) had recorded functional vision in one or both eyes, whereas two others could potentially be having vision but could not be evaluated.
The long-term results of lens-sparing vitrectomy for stage 4 ROP are favorable with a majority retaining clear lenses and attached retina and two-thirds having functional vision.
报告晶状体保留玻璃体切除术（LSV）治疗4期早产儿视网膜病变（ROP）的长期解剖和功能结果。
回顾性研究。
本研究纳入了16例4期ROP患者的23只眼，这些患者在一家三级医疗中心接受了晶状体保留玻璃体切除术，并至少随访了2年。主要观察指标为末次随访时的视网膜状态和视力结果。
平均随访7.36年后，69.57%的晶状体保持透明；19/23只眼（82.61%）在视网膜附着方面取得了解剖学成功，8/23只眼（34.78%）达到了≥6/24的视力，而16/23只眼（69.56%）达到了导航视力（≥1/60）。平均球镜等效度数为-8.50 + 6.39屈光度。43.47%的患者存在高度近视（≥7 dsph）。近视的严重程度与既往激光治疗无关，与正常眼底或有黄斑牵拉但无褶皱的眼睛相比，后极部残留褶皱的眼睛近视程度较轻。在末次随访时，3/16（18.75%）的患者因视网膜完全脱离而双目失明，11/16（68.75%）的患者一只或两只眼睛记录到了功能性视力，另外两名患者可能有视力，但无法评估。
晶状体保留玻璃体切除术治疗4期ROP的长期结果良好，大多数患者晶状体保持透明、视网膜附着，三分之二的患者有功能性视力。
