Visual acuity of eyes after vitrectomy for ROP: Follow-up at 5-1/2 years

PURPOSE: To provide long-term follow-up on retinal structure and visual function of 72 eyes (54 patients) that underwent lensectomy-vitrectomy for total retinal detachment (RD) from ROP and 56 eyes (44 patients) that had total RD from ROP but did not undergo lensectomy-vitrectomy. METHODS: All patients were participants in the multicenter study of cryotherapy for ROP, and all had developed total RD by the the 3-month study examination. Lensectomy-vitrectomy, which was performed at the discretion of the child's retinal specialist, was carried out prior to the 12-month study examination. When children reached 5-1/2 years of age, an eye examination was performed and residua of ROP assessed. Recognition acuity (ETDRS chart) and grating acuity (Teller acuity card procedure) were measured by testers masked to the status of each of the child's eyes. RESULTS: At 5-1/2 years, partial attachment of the retina was present in 21% of eyes that underwent vitrectomy and in 3% of eyes that did not undergo vitrectomy, as compared with 28% and 10% at age one year (differences n.s.). Evidence of minimal pattern vision was present in one eye that had undergone vitrectomy. All other eyes had vision limited to light perception or no light perception. Two eyes that had minimal pattern vision at 1 year had no pattern vision at long-term follow-up. CONCLUSIONS: Poor visual outcome after vitrectomy for RD due to ROP demands that emphasis be placed on prevention of RD in preterm infants.