Purpose: To review the surgical outcome of plasmin enzyme-assisted vitreoretinal surgery in managing stage 5 retinopathy of prematurity (ROP).
Methods: A retrospective, consecutive interventional cases series of 80 eyes (68 patients) with stage 5 ROP, treated with autologous or maternal plasmin enzyme-assisted vitreoretinal surgery, were reviewed. All study patients underwent surgery between 1995 and 2004 with plasmin enzyme-assisted vitreoretinal surgery. Thirty-eight eyes had previous vitreous surgery without retinal breaks (Group 1). Fifteen eyes had previous vitreous surgery with retinal breaks (Group 2). Twenty eyes received previous laser, and/or cryotherapy, and/or scleral buckling, but no vitrectomy (Group 3). Seven eyes did not receive any treatment previously (Group 4).
Results: Postoperative anatomic outcome, functional results, and surgical complications in each group of eyes at an average follow-up of 49 months were recorded. Following surgery of all 80 eyes, anatomic success was achieved in 68.8%. Six eyes (7.5%) achieved 20/60 to 20/600 vision. Fifty-nine eyes (73.8%) achieved vision worse than 20/600 to light perception. Eleven eyes (13.8%) achieved no light perception. Visual results were uncertain in 4 eyes (5%) because of the inability to measure reliably.
Conclusion: Plasmin enzyme-assisted vitrectomy in eyes with and without previous vitrectomy surgery can achieve visual improvement in stage 5 ROP. Early intervention with vitreous surgery for stage 4A ROP will achieve better anatomic and visual results and reduce the number of children with stage 5 ROP.