Early vitreous surgery for aggressive posterior retinopathy of prematurity

PURPOSE: To assess the efficacy of early vitrectomy for aggressive posterior retinopathy of prematurity (ROP) to stop progression of retinal detachment. DESIGN: Retrospective, noncomparative, consecutive case series. METHODS: Twenty-two eyes (15 patients) with aggressive posterior ROP underwent vitrectomy with or without lens sparing, because retinal photocoagulation failed to stop progression of fibrovascular proliferation, despite being performed early, densely, and with early retreatment. We assessed the status of retinal attachment and foveal formation ophthalmoscopically and the presence or absence of fixation of visual behavior. RESULTS: Follow-up ranged from six to 12 months (mean, 9 months). Six eyes (100%) in which a lens,sparing vitrectomy was performed developed a large tractional retinal detachment. In contrast, the retinas were completely reattached in 16 eyes (100%) in which vitrectomy with lensectomy was performed, nine eyes (56%) had foveal configuration, and 14 eyes (88%) had steady fixation. CONCLUSIONS: These results suggest that early vitrectomy is effective for preventing retinal detachment in aggressive posterior ROP.