Vitrectomy for advanced stages of retinopathy of prematurity.

We did a retrospective review of the consecutive vitrectomies for traction retinal detachment associated with retinopathy of prematurity performed at our institution. Fifty-eight eyes were operated on in 46 patients at less than 1 year of age, including 12 eyes with partial retinal detachments and 46 eyes with total retinal detachments. Only patients with at least six months follow-up were considered for success. Twenty-five eyes (43%) were anatomically reattached. Factors associated with good anatomic outcome included greater mean preoperative pupillary dilation, absence of posterior synechiae, deep anterior chamber, partial detachment or open-funnel total detachment configuration, and adequate posterior membrane removal. Of the 25 eyes with attached retinas, 11 had fixing and following visual acuities or better. Three eyes with attached retinas had no light perception and 11 eyes with attached retinas had light perception only. To maximize anatomic and functional results we emphasize the need to operate early, when the retinal funnel is still open.