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Scleral buckling surgery for stage 4A and 4B retinopathy of prematurity in critically ill neonates

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Abstract

Purpose

To determine the efficacy of scleral buckling in eyes with stage 4A and 4B retinopathy of prematurity (ROP).

Methods

Seven eyes of five premature infants underwent scleral buckling for stage 4 ROP in zone II. Five eyes had stage 4A ROP, and two eyes had stage 4B ROP. Six eyes had previous diode laser photocoagulation, and one eye had received an intravitreal ranibizumab injection. Scleral buckling was the procedure of choice due to lack of access to specialized pediatric vitrectomy instrumentation. Average age at surgery was 3.4 months. Postoperative anatomic retinal status, visual acuity outcome and refractive error were assessed.

Results

The scleral buckle was removed on average 8 months after surgery. Retinal reattachment was achieved in all seven eyes. At final follow-up one eye had macular ectopia and disc dragging, one eye had a macular traction fold and two eyes had optic disc pallor. Average myopic error after buckle removal was −7.5 D.

Conclusion

Scleral buckling can be performed safely and effectively in 4A and 4B stage ROP in critically ill infants, when access to specialized pediatric vitrectomy instrumentation is limited. This surgical technique may provide adequate relief of vitreoretinal traction with improved visual potential.

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Fig. 1
Fig. 2

source optical coherence tomography (SS-OCT) in Case 3 obtained before SB: Cystoid macular edema with a single subfoveal cystoid structure is present in the left eye

Fig. 3

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Funding

No funding was received to assist with the preparation of this manuscript.

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Authors and Affiliations

  1. Department of Ophthalmology, University Hospital of Larissa, Mezourlo Area, 41222, Larissa, Greece

    Eleni Papageorgiou, Konstantina Riri, Dimitrios Kardaras, Evangelia E. Tsironi & Sofia Androudi

  2. Neonatal Intensive Care Unit, University Hospital of Larissa, Larissa, Greece

    Ioanna Grivea

  3. Department of Ophthalmology, Papageorgiou Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece

    Asimina Mataftsi

Authors
  1. Eleni Papageorgiou
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  2. Konstantina Riri
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  3. Dimitrios Kardaras
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  4. Ioanna Grivea
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  5. Asimina Mataftsi
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  6. Evangelia E. Tsironi
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  7. Sofia Androudi
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Contributions

All authors contributed equally to this work.

Corresponding author

Correspondence to Konstantina Riri.

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Conflict of interest

The authors have no conflicts of interest to declare that are relevant to the content of this article. This paper has been presented in part at the annual meeting of Euretina 2020, Virtual, October 2, 2020.

Ethical approval

This study was performed in line with the principles of the Declaration of Helsinki. Approval was granted by the Ethics Committee of University Hospital of Larissa.

Consent to participate: Written informed consent was obtained from the patients’ parents.

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Patients’ parents signed informed consent regarding publishing their data and photographs.

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Papageorgiou, E., Riri, K., Kardaras, D. et al. Scleral buckling surgery for stage 4A and 4B retinopathy of prematurity in critically ill neonates. Int Ophthalmol 42, 1093–1100 (2022). https://doi.org/10.1007/s10792-021-02095-3

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  • DOI: https://doi.org/10.1007/s10792-021-02095-3

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