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Stages 4 and 5 ROP represent a severe form of ROP resulting in visual blindness. Pars plana lvitrectomy with or without lensectomy may offer a dismal prognosis in fixing the retinal detachment.


A series of 15 consecutive cases of severe tractional retinal detachment and falciform folds presenting as stages 4 (8 cases) and 5 ROP (7 cases) progressing following laser application +/- intravitreal avastin were managed by pars plicata vitrectomy with or without lensectomy. Mean age was 6.3 months. Mean time to retinal reposition and flattening was 8.7 months. Recoverable vision was noted in all children with correction of refractive errors when necessary.


Pars plana vitrectomy with or without lensectomy presents a last hope in stages 4and 5 ROP with total tractional retinal detachment.

Take home message:

In desperate situations, desperate measures should be taken as a little gain in vision is better than no vision. Hope always exist.