Efficacy of scleral buckling for stage 4A retinopathy of prematurity

ABSTRACT

To evaluate the anatomical and functional outcome of scleral buckling [SB] for stage 4A retinopathy of prematurity [ROP]. Retrospective, non-comparative, consecutive, interventional case series study. Five eyes of five patients with stage 4A ROP were enrolled. All eyes were selected from consecutive patients treated with SB and then division of the encircling band. Patient characteristics, including gestational age. birth weight, gender, corrected gestational age at time of surgery, surgical procedure, anatomic outcome, ability to fix and follow and refractive changes were recorded. All eyes had a complete retinal reattachment [ +/- macular ectopia] at a mean follow-up of 43.4 months [range 38-50 months]. Final visual acuity ranged from 20/50 to 20/200. Fixation was central in 2 eyes and remaining eyes with poorer vision had eccentric fixation due to macular ectopia. Mean refractive error in spherical equivalents was -8.4 D [range -5.50 to -12.00 D]. Scleral buckling for stage 4A retinopathy of prematurity is an effective means of preventing further progression of retinal detachment. This encircling procedure induces large myopic shift by way of increasing the axial length. This highlights the importance of repeated refraction testing in these eyes to prevent refractive amblyopia