Our Summary

This research paper is about a study conducted on the use of two treatments together for a serious eye condition in infants called retinopathy of prematurity (ROP), specifically in its more severe stages (Stage 4 and 5). The condition can lead to problems like bleeding and the retina (the layer at the back of the eye) detaching.

The two treatments are an injection into the eye of a drug called bevacizumab and the placement of a small band around the eye (scleral buckle). These were used together in an attempt to reduce the above-mentioned problems.

The researchers looked back at the results of this combined treatment on 13 eyes from 10 infants. They found that all the eyes in the less severe stage (Stage 4) were successfully reattached at the back of the eye. However, some needed another surgery called vitrectomy. All the eyes in the more severe stages (Stage 4b or 5) required this additional surgery.

In conclusion, the researchers suggest that using both treatments together can be a stepping stone to the additional surgery and in some cases, prevent the need for this surgery.

FAQs

  1. What is the purpose of using concurrent intravitreal bevacizumab and scleral buckle in treating Stage 4 and 5 retinopathy of prematurity?
  2. What were the results of the retrospective analysis of eyes treated with concurrent intravitreal bevacizumab and scleral buckle?
  3. Could the concurrent use of intravitreal bevacizumab and scleral buckle potentially eliminate the need for future interventions in some cases?

Doctor’s Tip

A helpful tip a doctor might give a patient about scleral buckle surgery is to follow post-operative instructions carefully, including avoiding heavy lifting or strenuous activities, taking prescribed medications as directed, and attending all follow-up appointments to monitor healing and ensure the best possible outcome.

Suitable For

Patients with Stage 4 or 5 retinopathy of prematurity (ROP) are typically recommended scleral buckle surgery, especially when they are also undergoing intravitreal bevacizumab treatment. This combination of treatments can help reduce the risk of tractional retinal detachment and improve the chances of successful retinal reattachment. In some cases, concurrent intravitreal bevacizumab and scleral buckle surgery may even eliminate the need for further interventions such as vitrectomy.

Timeline

Before scleral buckle surgery:

  • Patient is diagnosed with Stage 4 or 5 retinopathy of prematurity (ROP)
  • Intravitreal bevacizumab may be used preoperatively to reduce vascular endothelial growth factor load and bleeding risk
  • Bevacizumab may induce traction and exacerbate a tractional retinal detachment

After scleral buckle surgery:

  • Retrospective analysis is performed on eyes treated with concurrent intravitreal bevacizumab and scleral buckle
  • Retinal reattachment and need for vitrectomy are studied
  • All eyes with Stage 4 ROP achieve macular attachment at last follow-up
  • Eyes with Stage 4a ROP achieve retinal reattachment with either buckle alone or subsequent vitrectomy
  • Eyes with Stage 4b or 5 ROP require vitrectomy
  • Concurrent intravitreal bevacizumab and scleral buckle may serve as a bridge to vitrectomy and, in some instances, may obviate the need for subsequent intervention.

What to Ask Your Doctor

  1. What is the purpose of the scleral buckle in conjunction with intravitreal bevacizumab for Stage 4 or 5 retinopathy of prematurity?
  2. How will the scleral buckle affect the recovery process compared to receiving intravitreal bevacizumab alone?
  3. What are the potential risks and complications associated with scleral buckle surgery?
  4. How long is the recovery time after scleral buckle surgery, and what can I expect during the healing process?
  5. Will the scleral buckle need to be removed at a later date, or is it a permanent implant?
  6. What are the chances of needing additional procedures, such as vitrectomy, after receiving a scleral buckle?
  7. How will the scleral buckle impact my vision in the long term?
  8. Are there any specific post-operative care instructions I should follow to ensure the success of the surgery?
  9. How experienced are you in performing scleral buckle surgery, and what is your success rate with this procedure?
  10. Are there any alternative treatments or procedures that I should consider before moving forward with scleral buckle surgery?

Reference

Authors: Shah RJ, Garcia-Gonzalez JM, Blair MP, Galasso J, Shapiro MJ. Journal: Retin Cases Brief Rep. 2016 Spring;10(2):183-6. doi: 10.1097/ICB.0000000000000221. PMID: 26650563