Scleral Buckling for Stage 4 Retinopathy of Prematurity

Abstract

BACKGROUND AND OBJECTIVE: Both vitrectomy and scleral buckling have been used to treat patients with stage 4 retinopathy of prematurity (ROP). The standard procedure of scleral buckling for treatment of stage 4 ROP is encircling scleral buckling. The effectiveness of segmental scleral buckling is still unclear. The purpose of this study was to analyze the surgical results of patients with stage 4 retinopathy of prematurity treated with either encircling or seg mental scleral buckling. PATIENTS AND METHODS: We retrospectively analyzed the anatomic outcomes of 23 eyes ( 18 infants) with stage 4 A or B ROP treated with scleral buckling. Segmental buckling was used to treat 15 eyes with detachment limited to the temporal side of the retina, while 9 eyes with detachment involving both the nasal and temporal sides were treated with encircling scleral buckling . RESULTS: Macular reattachment during a mean follow-up periord of 34 months (range: 2 weeks to 3 years) was accomplished in 11 (79%) of the 14 eyes treated with segmental scleral buckling and 4 (44%) of the 9 eyes that received encircling scleral buckling. There were no intraoperative complications recorded. None of the eyes that achieved macular reattachment developed recurrent macular detachment during the follow-up period. CONCLUSIONS: Scleral buckling appears to be effective for treatment of stage 4 ROP. In patients with temporal side retinal detachment only, Segmental scleral buckling provides adequate treatment for stage 4 ROP.