Endoscopic vitrectomy for stage 4 ROP

Summary Introduction Retinal detachment ( RD ) surgery in ROP is complex. Safe surgical access into the vitreous cavity is a challenge with a significant risk of requiring primary lensectomy with long term ocular morbidity risk. Endoscopic vitrectomy (Endo‐Vit) is a novel surgical approach, enabling a different intraoperative surgeon's perspective that may addresses some of the surgical challenges. Purpose To evaluate the efficacy and safety of Endo‐Vit for traction RD in ROP . Setting Great Ormond Street Hospital for Children, London. Methods Single centre noncomparative consecutive series of surgery for stage 4 ROP . Inclusion criteria was stage 4A or 4B ROP , with stage 5 excluded. Results Eighteen eyes of 14 patients were included. Mean gestational age, birth weight and follow‐up were 25.3 weeks, 794g and 3 months, respectively. RD stage was 4A in 7 eyes, and 4B in 11 eyes. Median age at primary Endo‐Vit was 45.8 weeks post menstrual age. Median number of surgeries was 1. Overall, primary retinal re‐attachment was 89%, 100% in 4A, and 82% in 4B. None required primary lensectomy. Conclusions Endo‐Vit reduces the need for primary lensectomy in stage 4 ROP compared to standard techniques, with favourable anatomic outcomes.