Abstract
BACKGROUND: Surgery for stages 4 and 5 of retinopathy of prematurity (ROP) is challenging. The long-term results even in initially successful cases are not satisfactory. Data on long-term results are sparse. METHODS: Retrospective analysis of patients with stages 4 and 5 of ROP who underwent surgery at a tertiary care center and had a minimum follow-up of 5 years. Most stage 4 a and 4b were managed by scleral buckling or lens sparing vitrectomy, while most stage 5 needed lens sacrificing vitrectomy. The anatomical success was assessed at 6 weeks postsurgery and again at the last follow-up, while the visual success was assessed only at final follow-up visit. RESULTS: 84 eyes of 60 patients with a mean follow-up of 9.27 years were analyzed. The mean age at presentation was more in stage 5 ROP compared to stage 4a and 4b (P < 0.001). Overall anatomical success was seen in 94.2% of stage 4a, 82.35% of stage 4b, and 63.6% of stage 5 at 6 weeks, which deteriorated to 88.2% in stage 4a, 70.59% in stage 4b, and 30.3% in stage 5 at the end of last follow-up. At last visit, the highest level of corrected vision attained was 6/9 in stage 4a, 6/18 in stage 4b, and 6/60 in stage 5 ROP. CONCLUSIONS: Anatomical and visual results are better with stages 4a and 4b compared to stage 5 ROP. On long-term follow-up, the incidence of recurrent retinal detachment is highest in stage 5 ROP.