Surgery for stage 5 retinopathy of prematurity: the learning curve and evolving technique. 2000

L Gopal, and T Sharma, and M Shanmugam, and S S Badrinath, and A Sharma, and S G Agraharam, and A Choudhary
Medical and Vision Research Foundation, Chennai, India. MDSAAA35@giasmd01.vsnl.net.in

OBJECTIVE To describe our experience with management of eyes with stage 5 retinopathy of prematurity (ROP). METHODS Closed vitreoretinal surgery was done on 96 eyes of patients with stage 5 ROP. Lens was sacrificed in all but one eye. Surgery involved an attempt to clear all preretinal tissue and open the peripheral trough all round. In most instances bimanual surgery under viscoelastic was performed. RESULTS At last follow up, anatomical success (defined as attached posterior pole) was achieved in 22.5% cases. Significant postoperative problems included reproliferation and secondary glaucoma. Only two infants obtained mobile vision. CONCLUSIONS Late identification of disease, lack of prior treatment such as laser or cryo, and higher incidence of narrow-narrow funnel configuration were responsible for the poor surgical results noted in this series. The poor surgical and functional results reemphasize the need for prompt screening and management of infants at risk.

UI MeSH Term Description Entries
D007223 Infant A child between 1 and 23 months of age. Infants
D007231 Infant, Newborn An infant during the first 28 days after birth. Neonate,Newborns,Infants, Newborn,Neonates,Newborn,Newborn Infant,Newborn Infants
D007908 Lens, Crystalline A transparent, biconvex structure of the EYE, enclosed in a capsule and situated behind the IRIS and in front of the vitreous humor (VITREOUS BODY). It is slightly overlapped at its margin by the ciliary processes. Adaptation by the CILIARY BODY is crucial for OCULAR ACCOMMODATION. Eye Lens,Lens, Eye,Crystalline Lens
D008297 Male Males
D009885 Ophthalmology A surgical specialty concerned with the structure and function of the eye and the medical and surgical treatment of its defects and diseases. Ocular Surgery,Ocular Surgeries,Surgery, Ocular
D012086 Reoperation A repeat operation for the same condition in the same patient due to disease progression or recurrence, or as followup to failed previous surgery. Revision, Joint,Revision, Surgical,Surgery, Repeat,Surgical Revision,Repeat Surgery,Revision Surgery,Joint Revision,Revision Surgeries,Surgery, Revision
D002983 Clinical Competence The capability to perform acceptably those duties directly related to patient care. Clinical Skills,Competence, Clinical,Clinical Competency,Clinical Skill,Competency, Clinical,Skill, Clinical,Skills, Clinical,Clinical Competencies,Competencies, Clinical
D005260 Female Females
D006801 Humans Members of the species Homo sapiens. Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D012178 Retinopathy of Prematurity A bilateral retinopathy occurring in premature infants treated with excessively high concentrations of oxygen, characterized by vascular dilatation, proliferation, and tortuosity, edema, and retinal detachment, with ultimate conversion of the retina into a fibrous mass that can be seen as a dense retrolental membrane. Usually growth of the eye is arrested and may result in microophthalmia, and blindness may occur. (Dorland, 27th ed) Retrolental Fibroplasia,Fibroplasia, Retrolental,Fibroplasias, Retrolental,Prematurity Retinopathies,Prematurity Retinopathy,Retrolental Fibroplasias

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