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Retinal Surgery for Late Retinal Detachment in Patients with Former Prematurity

Jandeck C., Kellner U., Foerster M. H.,
Freie Universität Berlin, Klinikum Benjamin Franklin, Augenklinik (Berlin)

Purpose: To describe the indications and results of retinal surgery for rhegmatogenous retinal detachment (RD) in former premature patients with and without retinopathy of prematurity (ROP).
Patients and Methods: Between 1995 and 2002 a vitrectomy was performed in a consecutive series of 12 eyes of 11 patients. 5 males and 6 females aged from 9 to 42 years (median 15,0 years), were treated. Gestational age was 26-32 weeks and birth weight was 810-1475 grams.
Results: During acute phase ROP one child was treated with cryotherapy. The other eyes were untreated. 10/12 eyes were myopic (-2.5 to -17.5). Three patients initially presented with a vitreous hemorrhage and a RD was detected during ultrasound examination.Nine eyes had peripheral retinal changes due to ROP. In 11 eyes a vitrectomy without scleral buckling was performed. Seven eyes were treated with SF6 tamponade and 4 eyes with silicone oil tamponade. In one eye only an encircling band was used. Patients were followed for 5 months to 7 years (mean 24.6 months). At the end of follow-up the retina was completely attached in 9 eyes. One eye was phthitic and two eyes developed an optic atrophy with peripheral RD. These 3 eyes needed a permanent silicone oil tamponade. Two eyes with cicatricial changes of ROP needed multiple procedures (with silicone oil) for reattachment. Visual acuity ranged from light projection to 0,8.
Conclusions: Patients with a history of premature birth may develop a rhegmatogenous retinal detachment even in eyes without clinically visible retinal changes of ROP. Eyes with cicatricial stages of ROP required multiple procedures for stabilization. Former premature should be followed and informed about the symptoms and possibility of retinal problems.